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. 2017 Oct 28;23(40):7292-7302.
doi: 10.3748/wjg.v23.i40.7292.

Clinical and pathological characterization of Epstein-Barr virus-associated gastric carcinomas in Portugal

Joana Ribeiro  1 , Andreia Oliveira  1 , Mariana Malta  1 , Claudia Oliveira  1 , Fernanda Silva  2 , Ana Galaghar  2 , Luís Pedro Afonso  2 , Maria Cassiano Neves  3 , Rui Medeiros  1 , Pedro Pimentel-Nunes  4 , Hugo Sousa  1
Affiliations

Clinical and pathological characterization of Epstein-Barr virus-associated gastric carcinomas in Portugal

Joana Ribeiro et al. World J Gastroenterol. .

Abstract

Aim: To determine the prevalence of Epstein-Barr virus (EBV)-associated gastric carcinomas in the North Region of Portugal and to study its clinicopathological characteristics.

Methods: We have performed a retrospective study including a total of 179 consecutive patients with gastric cancer (GC) submitted to gastrectomy during 2011 at the Portuguese Oncology Institute of Porto. Clinical and pathological data was collected from individual clinical records and inserted on a database with unique codification. Tumour tissues were collected from the institutional tumour bank. EBV was detected by in situ hybridization for the detection of EBV-encoded small RNAs (EBERs) and EBV latent proteins (LMP1 and LMP2A) were detected by immunohistochemistry.

Results: The analysis showed that EBV-associated gastric carcinomas (EBVaGC) represents 8.4% (15/179) of all GC cases, with a significant differential distribution among histological types (P < 0.001): 100% (3/3) of medullary carcinomas, 100% (1/1) of adenosquamous carcinoma, 8.7% (8/92) of tubular adenocarcinomas, 8.0% (2/25) of mixed carcinomas and 2% (1/51) in poorly cohesive carcinomas. The analysis revealed a higher predominance of EBVaGC in the upper third and middle (cardia, fundus and body) of the stomach (P = 0.041), a significant lower number of regional lymph nodes invasion (P = 0.025) and a tendency for better prognosis (P = 0.222). EBV latent protein expression revealed that all EBVaGC cases were LMP1-negative, nevertheless 6 cases (40%) expressed LPM2A, which reveals that these cases show a distinct EBV-Latency profile (latency II-like).

Conclusion: EBVaGC represents 8.4% of all GC in the North Region of Portugal. The EBV-infected patients have specific clinic-pathological features that should be further explored to develop new strategies of management and treatment.

Keywords: Epstein-Barr virus; Epstein-Barr virus-associated gastric carcinomas; Gastric cancer; Prevalencel.

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Conflict of interest statement

Conflict-of-interest statement: Authors declare no conflict of interests in the reported study.

Figures

Figure 2
Figure 2
Kaplan-Meier survival curves for overall survival. Comparison of overall survival in gastric cancer patients considering: A: Regional lymph node metastasis; B: Lymphovascular permeation; C: Perineural permeation; and D: Invasive pattern.
Figure 1
Figure 1
Representative images of EBER-ISH positive results in different histological types of gastric cancer and their respective HE staining. A: Adenocarcinoma tubular; B: Adenocarcinoma tubular; C: Adenocarcinoma Mixed; D: Adenosquamous Carcinoma; E: Medullary caricnoma. HE: Hematoxylin and eosin stain; EBERs: EBV-encoded small RNAs. Figure 1 Representative images of EBER-ISH positive results in different histological types of gastric cancer and their respective HE staining. A: Adenocarcinoma tubular; B: Adenocarcinoma tubular; C: Adenocarcinoma Mixed; D: Adenosquamous Carcinoma; E: Medullary caricnoma. HE: Hematoxylin and eosin stain; EBERs: EBV-encoded small RNAs.
Figure 3
Figure 3
Comparison of overall survival in patients with Epstein-Barr virus-associated gastric carcinomas and Epstein-Barr virus-non associated gastric cancer. Kaplan-Meier curves with log-rank test estimate the overall survival of gastric cancer patients with and without Epstein-Barr virus (EBV)-associated gastric cancer.
See this image and copyright information in PMC

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