The Clinicopathological Features and Genetic Alterations in Epstein–Barr Virus-Associated Gastric Cancer Patients after Curative Surgery
Open Access
- 10 June 2020
- Vol. 12 (6), 1517
- https://doi.org/10.3390/cancers12061517
Abstract
Background: Epstein–Barr virus (EBV)-associated gastric cancer (GC) is one of four major gastric cancer types and is traditionally considered to be related to lymphoepithelioma-like GC. Few studies have investigated the clinical significance of EBV infection in intestinal/solid type, diffuse (poorly cohesive) type, and lymphoepithelioma-like GC. Methods: A total of 460 GC patients receiving curative surgery were enrolled. The clinicopathological features, genetic alterations and prognoses were compared between patients with and without EBV infection. Results: EBV-positive GC patients (n = 43) had more tumors located in the upper and middle stomach, more common in lymphoepithelioma-like carcinoma, more lymphoid stroma, fewer Helicobacter pylori infections, and higher programmed death-ligand 1 (PD-L1) expression than EBV-negative GC patients. For intestinal/solid type GC, EBV-positive tumors were more likely to be located in the upper and middle stomach, have more lymphoid stroma, fewer Helicobacter pylori infections, higher PD-L1 expression, and more liver metastases than EBV-negative tumors. For diffuse (poorly cohesive) type GC, EBV-positive tumors were more likely to be located in the upper stomach, and have more lymphoid stroma than EBV-negative tumors. For lymphoepithelioma-like GC, EBV-positive tumors had more PI3K/AKT pathway mutations than EBV-negative tumors. Conclusions: Intestinal/solid type GC patients with EBV-positive tumors were associated with higher PD-L1 expression and more liver metastases, while lymphoepithelioma-like GC patients with EBV-positive tumors had more PI3K/AKT pathway mutations. Immunotherapy and targeted therapy may be beneficial for these groups of patients. Routine EBV survey is recommended in GC.Keywords
Funding Information
- Ministry of Science and Technology, Taiwan (107-2314-B-075 -007)
This publication has 51 references indexed in Scilit:
- Epstein-Barr Virus (EBV)-associated Gastric CarcinomaViruses, 2012
- LY294002 may overcome 5-FU resistance via down-regulation of activated p-AKT in Epstein-Barr virus-positive gastric cancer cellsBMC Cancer, 2010
- Relationship between H.Pylori infection and clinicopathological features and prognosis of gastric cancerBMC Cancer, 2010
- The Src/PI3K/Akt signal pathway may play a key role in decreased drug efficacy in obesity‐associated cancerJournal of Cellular Biochemistry, 2010
- Clinicopathological and molecular characteristics of Epstein–Barr virus‐associated gastric carcinoma: A meta‐analysisJournal of Gastroenterology and Hepatology, 2009
- Characteristics of Epstein-Barr virus-associated gastric cancer: A study of 235 cases at a comprehensive cancer center in U.S.AJournal of Experimental & Clinical Cancer Research, 2009
- Adjuvant Chemotherapy for Gastric Cancer with S-1, an Oral FluoropyrimidineThe New England Journal of Medicine, 2007
- LMP1 signaling and activation of NF-κB in LMP1 transgenic miceOncogene, 2005
- BRAF and KRAS mutations in stomach cancerOncogene, 2003
- Intravenous immunoglobulins in infectious diseases: where do we stand?Clinical Microbiology & Infection, 2003