Prognostic factors in Epstein-Barr virus-associated stage I-III gastric carcinoma: Implications for a unique type of carcinogenesis

  • Authors:
    • Shih-Chiang Huang
    • Kwai-Fong Ng
    • Kuang-Hua  Chen
    • Jun‑Te  Hsu
    • Keng-Hao Liu
    • Ta-Sen  Yeh
    • Tse-Ching  Chen
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  • Published online on: June 5, 2014     https://doi.org/10.3892/or.2014.3234
  • Pages: 530-538
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Abstract

Epstein-Barr virus-associated gastric carcinoma (EBVaGC) has distinct clinicopathological features. However, the prognostic factors remain unclear, particularly in UICC/AJCC stage I-III cancer. We retrospectively enrolled 1,020 patients with stage I-III gastric cancer that received radical gastrectomy with lymphadenectomy. Formalin-fixed, paraffin‑embedded surgical specimens were retrieved to construct tissue microarrays. EBV positivity was identified by in situ hybridization with EBV-encoded small RNA, and the histological classification was reviewed. Fifty-two cases of EBVaGC were identified, exhibiting a male predominance (p=0.003), a higher prevalence in stump cancer (p<0.001), and poorly differentiated carcinoma (p=0.010) compared with the controls. The survival analysis revealed no difference in survival between the EBVaGC cases and the EBV-negative cases (p=0.977). The multivariate analysis showed that EBVaGC cases with a tumor size >5 cm, non-lymphoepithelioma-like carcinoma (LELC), or a lymph node ratio >0.15 had a worse overall survival (hazard ratio 2.884, 12.178 and 19.352; p=0.027, 0.005 and <0.0001, respectively). The depth of tumor invasion and the number of lymph node metastases did not reach statistical significance (p=0.834 and 0.833, respectively). These prognostic factors, tumor size, LELC classification and lymph node ratio, may reflect a unique type of carcinogenesis of EBVaGC and may be considered when selecting high-risk patients for adjuvant treatment.
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August-2014
Volume 32 Issue 2

Print ISSN: 1021-335X
Online ISSN:1791-2431

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Spandidos Publications style
Huang S, Ng K, Chen K, Hsu JT, Liu K, Yeh T and Chen T: Prognostic factors in Epstein-Barr virus-associated stage I-III gastric carcinoma: Implications for a unique type of carcinogenesis. Oncol Rep 32: 530-538, 2014
APA
Huang, S., Ng, K., Chen, K., Hsu, J., Liu, K., Yeh, T., & Chen, T. (2014). Prognostic factors in Epstein-Barr virus-associated stage I-III gastric carcinoma: Implications for a unique type of carcinogenesis. Oncology Reports, 32, 530-538. https://doi.org/10.3892/or.2014.3234
MLA
Huang, S., Ng, K., Chen, K., Hsu, J., Liu, K., Yeh, T., Chen, T."Prognostic factors in Epstein-Barr virus-associated stage I-III gastric carcinoma: Implications for a unique type of carcinogenesis". Oncology Reports 32.2 (2014): 530-538.
Chicago
Huang, S., Ng, K., Chen, K., Hsu, J., Liu, K., Yeh, T., Chen, T."Prognostic factors in Epstein-Barr virus-associated stage I-III gastric carcinoma: Implications for a unique type of carcinogenesis". Oncology Reports 32, no. 2 (2014): 530-538. https://doi.org/10.3892/or.2014.3234