Determinants of Epstein-Barr virus-positive gastric cancer: an international pooled analysis

Abstract

Background:Meta-analyses of the published literature indicate that about 9% of gastric cancers contain Epstein-Barr virus (EBV), with consistent and significant differences by sex and anatomic subsite. This study aimed to identify additional determinants of EBV positivity and their joint effects.Methods:From 15 international populations with consistent laboratory testing for EBV, we pooled individual-level data for 5081 gastric cancer cases including information on age, sex, subsite, histologic type, diagnostic stage, geographic region, and period of diagnosis. First, we combined population-specific EBV prevalence estimates using random effects meta-analysis. We then aggregated individual-level data to estimate odds ratios of EBV positivity in relation to all variables, accounting for within-population clustering.Results:In unadjusted analyses, EBV positivity was significantly higher in males, young subjects, non-antral subsites, diffuse-type histology, and in studies from the Americas. Multivariable analyses confirmed significant associations with histology and region. Sex interacted with age (P=0.003) and subsite (P=0.002) such that male predominance decreased with age for both subsites. The positivity of EBV was not significantly associated with either stage or time period.Conclusion:Aggregating individual-level data provides additional information over meta-analyses. Distinguishing histologic and geographic features as well as interactions among age, sex, and subsite further support classification of EBV-associated gastric cancer as a distinct aetiologic entity.

Correlation Between Infection Status of Epstein-Barr Virus and 18F-Fluorodeoxyglucose Uptake in Patients with Advanced Gastric Cancer

“…EBV-associated gastric cancer type differs from other gastric cancers, exhibiting male predominance, non-antral anatomic subsites and better survival (6,7,17,18). Our results showed that EBVaGC was significantly more frequent in the higher metabolic tumor group than the lower metabolic group.…”

Epstein-Barr Virus-Encoded BARF1 Promotes Proliferation of Gastric Carcinoma Cells through Regulation of NF-κB

“…Gastric carcinoma is not only the most common EBVassociated malignancy in South Korea but the most common cancer overall in South Korea (8,9,41). EBV-positive gastric carcinomas show distinct clinicopathological characteristics, including lymphoid stroma (7,10), a higher prevalence in male patients and poorly differentiated WHO-type and diffuse Laurentype tumors (7,11), less frequent metastasis to lymph nodes (10), predominant localization to the proximal stomach (7,(10)(11)(12), unique expression of many cancer-related genes (7,9,12), and global CpG island methylation of cancer-related gene promoters (6).…”

Virus de Epstein-Barr y su relación con el desarrollo del cáncer

“…Se sabe que el CaGVEB se presenta en 2 % a 20 % de la población mundial. Anualmente se diagnostican de 200 000 a 876 000 casos nuevos de CaGVEB, que causan 69 081 a 90 000 muertes cada año (77,(80)(81)(82)(83). En Colombia, la tasa más alta de mortalidad por CaGVEB se reporta en regiones montañosas y la más baja, en regiones planas; es más frecuente en hombres jóvenes y el subtipo histológico predominante es el adenocarcinoma de tipo difuso (84).…”