Epstein-Barr virus and gastric remnant cancer

Abstract

Background. Carcinoma arising in the gastric remnant many years after partial gastrectomy for benign disease, referred to as gastric remnant cancer (GRC) is well known, and many causal explanations have been proposed. Elsewhere, Epstein‐Barr virus (EBV) involvement has been demonstrated in a small but significant fraction of gastric cancers, and evidence has been presented suggesting that, in positive cases, EBV may have played a causal role. The present report is concerned with EBV involvement in GRC in particular. Methods. Paraffin sections from 48 cases of GRC were studied by EBER‐1 in situ hybridization. Results. Thirteen cases (27.1%) showed uniform hybridized signals restricted to the carcinoma cells in contrast to no hybridization in the normal mucosa, intestinal metaplasia, or hyperplastic epithelium. The prevalence of EBV involvement in GRC was significantly higher (P < 0.0001) than in gastric carcinomas from 1825 nonremnant cases; the difference remained highly significant even when the comparison was restricted to nonremnant cancers arising in the cardia and middle stomach, for which EBV‐ positive rates were highest. Conclusion. The EBV may play an important role in the carcinogenesis of GRC.

Detection of Epstein-Barr Virus Infection in Gastric Carcinoma Using In Situ Polymerase Chain Reaction and Analysis of Epstein-Barr Virus-Associated Gastric Carcinoma

“…According to these reports, the pathologic features of EBVaGC are male predominance, occurrence primarily in the upper part of the stomach, moderately or poorly differentiated histological type, and a tendency for lymphocyte infiltration. By macroscopic typing of advanced cancer, elevated lesions with ulcer and scarce infiltration tendency were observed 23,26,27) The frequency of EBVaGC is the same from early gastric cancer to advanced gastric cancer"7.…”

Risk of Upper Gastrointestinal Cancer after Bariatric Operations

“…8 This bacterium has not been found to be specific in the patients presenting with dysplasia or adenocarcinoma of the gastric remnant, but in the endoscopic surveillance study after partial gastrectomy of Giuliani et al, 9 the prevalence of intestinal metaplasia was four times higher in HPpositive patients (19.6% vs 4.6%). Ebstein-Barr virus was also suggested as a potential co-factor by Yamamoto 10 et al associated with gastric remnant cancer after partial gastrectomy.…”

Variants of Gastric Carcinoma: Morphologic and Theranostic Importance

“…Another interesting characteristic of EBV-associated gastric carcinoma is its higher occurrence among gastric remnant carcinomas, ranging from 27% to 42% [31][32][33]. Chen et al hypothesizes that the injuries of gastric mucosa and/or changes of the microenvironment within the remnant stomach may be involved in the development of EBV-associated gastric carcinoma [34].…”