Prognostic significance of Epstein-Barr virus infection in gastric cancer: a meta-analysis

Abstract

BackgroundThe prognostic significance of Epstein-Barr virus (EBV) infection in gastric cancer (GC) remains unclear. Recently, a number of studies have investigated the association between EBV infection and the prognosis of GC with controversial results. We therefore conducted a meta-analysis to assess its prognostic significance.MethodsPubMed and EMBASE were searched for studies up to October 1, 2014. We investigated the association between EBV infection with survival in patients with GC. The pooled hazard ratio (HR) and its 95 % confidence interval (CI) were calculated to evaluate risk.ResultsA final analysis of 8,336 patients with GC from 24 studies was performed. Our analysis results indicated that the pooled HR was 0.67 (95 % CI: 0.55–0.79; Z = 11.18, P < 0.001). Subgroup analyses stratified by region revealed that the protective role of EBV infection only remained in the Asian population (HR: 0.62, 95 % CI: 0.48–0.75; P < 0.001). When stratified by study quality and statistical methodology, the protective role could also be identified in high quality studies (HR: 0.67, 95 % CI: 0.55–0.79) and in univariate analysis studies (HR: 0.62, 95 % CI: 0.50–0.74). There was no evidence of significant heterogeneity and publication bias.ConclusionsThe presence of EBV has a favorable impact on GC patient’s survival, especially in an Asian population. Future updated studies, especially large-scale randomized controlled studies stratified by region, are warranted as validation studies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1813-9) contains supplementary material, which is available to authorized users.

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

“…En cuanto al primer mecanismo, se ha encontrado que EBNA-1 es esencial para mantener el estado de latencia del VEB en el CG y es el único antígeno del virus expresado en todas las neoplasias asociadas al mismo (85,86). Los EBER están sobreexpresados en el CG de tipo intestinal cuando se compara con el de tipo difuso; se ha demostrado que estos micro-ARN están involucrados en los siguientes fenómenos: oncogénesis, adhesión celular, señales de transducción, regulación de la apoptosis, expresión y secreción del factor de crecimiento similar a la insulina y del factor de crecimiento autocrino de las células gástricas canceríge-nas (75,85,87).…”

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

“…We retrospectively enrolled patients who had confirmed gastric cancer and underwent 18 F-FDG PET/CT prior to therapy followed by curative surgical resection from August 2014 to July 2016 at Seoul St. Mary's hospital. Clinicopathologic data were retrospectively reviewed.…”

“…All patients fasted for at least 6 h before the 18 F-FDG PET/CT study. 18 F-FDG (3.7-4.4 MBq/kg) was injected intravenously and scanning began 60 min later. No intravenous contrast agent was used.…”

“…several reports have studied the correlation of 18 F-FDG PET/CT metabolic parameters and patient prognosis. These have demonstrated that high metabolic gastric cancers are related to poor prognosis (9)(10)(11).…”

“…Therefore, we evaluated the metabolic status of tumors using 18 F-FDG PET/CT according to EBV positivity in patients with advanced gastric cancer.…”