Clinical Significance of Epstein-Barr Virus and Helicobacter pylori Infection in Gastric Carcinoma
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Background/Aims: Epstein-Barr virus (EBV) and Helicobacter pylori (HP) coinfection may synergistically induce severe inflammatory responses in the stomach tissue, increasing the risk of developing gastric cancer. We aimed to analyze the effect of EBV and HP coinfection on the clinicopathologic features and prognosis of gastric cancer, as well as to evaluate the role of EBV infection in non-gastric carcinoma with lymphoid stroma (non-GCLS). Methods: Overall, 956 patients who underwent surgery for gastric cancer between September 2014 and August 2015 were eligible and divided into groups, according to GCLS morphology, EBV infection, and HP infection. Clinicopathologic characteristics and oncologic outcomes were analyzed retrospectively. Results: EBV and HP coinfection was significantly associated with male sex, proximal location, GCLS morphology, and equivocal p53 expression (p<0.001). Multivariate analysis revealed that EBV infection alone (hazard ratio [HR], 0.362; 95% CI, 0.131 to 0.996; p=0.049) and lower third location (HR, 0.624; 95% CI, 0.413 to 0.943; p=0.025) were inversely correlated with overall survival. During median follow-up period of 72 months, overall survival rate was not significantly different between the EBV and HP coinfection group and others (97.6% vs 86.8%, log-rank p=0.144). In non-GCLS patients (n=920), overall survival rate was not significantly different between the EBV infection group and others (96.9% vs 86.4%, log-rank p=0.126). Conclusions: EBV and HP coinfection is not an independent prognostic factor for gastric cancer. EBV infection status, regardless of HP infection, affects the clinicopathologic features of all types of gastric cancer. However, it does not lead to a significant difference in overall survival of non-GCLS patients.
Abstract
Background/Aims: Epstein-Barr virus (EBV) and Helicobacter pylori (HP) coinfection may synergistically induce severe inflammatory responses in the stomach tissue, increasing the risk of developing gastric cancer. We aimed to analyze the effect of EBV and HP coinfection on the clinicopathologic features and prognosis of gastric cancer, as well as to evaluate the role of EBV infection in non-gastric carcinoma with lymphoid stroma (non-GCLS). Methods: Overall, 956 patients who underwent surgery for gastric cancer between September 2014 and August 2015 were eligible and divided into groups, according to GCLS morphology, EBV infection, and HP infection. Clinicopathologic characteristics and oncologic outcomes were analyzed retrospectively. Results: EBV and HP coinfection was significantly associated with male sex, proximal location, GCLS morphology, and equivocal p53 expression (p<0.001). Multivariate analysis revealed that EBV infection alone (hazard ratio [HR], 0.362; 95% CI, 0.131 to 0.996; p=0.049) and lower third location (HR, 0.624; 95% CI, 0.413 to 0.943; p=0.025) were inversely correlated with overall survival. During median follow-up period of 72 months, overall survival rate was not significantly different between the EBV and HP coinfection group and others (97.6% vs 86.8%, log-rank p=0.144). In non-GCLS patients (n=920), overall survival rate was not significantly different between the EBV infection group and others (96.9% vs 86.4%, log-rank p=0.126). Conclusions: EBV and HP coinfection is not an independent prognostic factor for gastric cancer. EBV infection status, regardless of HP infection, affects the clinicopathologic features of all types of gastric cancer. However, it does not lead to a significant difference in overall survival of non-GCLS patients.
참고문헌 (24)
- Gomceli I, "Gastric carcinogenesis", World J Gastroenterol, 18, pp.5164~5170 (2012)
- Cancer Genome Atlas Research Network, "Comprehensive molecular characterization of gastric adenocarcinoma", Nature, 513, pp.202~209 (2014)
- Song HJ, "Host inflammatory response predicts survival of patients with Epstein-Barr virusassociated gastric carcinoma", Gastroenterology, 139, pp.84~92 (2010)
- Lim H, "Features of gastric carcinoma with lymphoid stroma associated with Epstein-Barr virus", Clin Gastroenterol Hepatol, 13, pp.1738~1744 (2015)
- Cárdenas-Mondragón MG, "Case–control study of Epstein–Barr virus and Helicobacter pylori serology in Latin American patients with gastric disease", Br J Cancer, 112, pp.1866~1873 (2015)
- Singh S, "Status of Epstein-Barr virus coinfection with Helicobacter pylori in gastric cancer", J Oncol, 2017, pp.3456264~ (2017)
- Rice TW, "8th edition AJCC", UICC staging of cancers of the esophagus and esophagogastric junction : application to clinical practice, 2017, pp.6, 119~130
- Lauwers GY, "WHO Classification of Tumours of the Digestive System", pp.48~58 (2010), International Agency for Research on Cancer
- Lee JY, "Diagnosis of Helicobacter pylori by invasive test : histology", Ann Transl Med, 3, pp.10~ (2015)
- McCluggage WG, "Patterns of p53 immunoreactivity in endometrial carcinomas : 'all or nothing'staining is of importance", Histopathology, 59, pp.786~788 (2011)
- Rüschoff J, "HER2 diagnostics in gastric cancer-guideline validation and development of standardized immunohistochemical testing", Virchows Arch, 457, pp.299~307 (2010)
- Naseem M, "Outlooks on Epstein-Barr virus associated gastric cancer", Cancer Treat Rev, 66, pp.15~22 (2018)
- Dávila-Collado R, "Epstein-Barr virus and Helicobacter pylori co-infection in non-malignant gastroduodenal disorders", Pathogens, 9, pp.104~ (2020)
- Matsusaka K, "DNA methylation in gastric cancer, related to Helicobacter pylori and Epstein-Barr virus", World J Gastroenterol, 20, pp.3916~3926 (2014)
- Cárdenas-Mondragón MG, "Epstein Barr virus and Helicobacter pylori co-infection are positively associated with severe gastritis in pediatric patients", PLoS One, 8, pp.e62850~ (2013)
- 조준훈, "Epstein-Barr Virus-Associated Gastric Carcinoma and Specific Features of the Accompanying Immune Response", Journal of Gastric Cancer, 16(1), pp.1~7 (2016), 대한위암학회[DOI]
- Camargo MC, "Improved survival of gastric cancer with tumour Epstein-Barr virus positivity : an international pooled analysis", Gut, 63, pp.236~243 (2014)
- Watanabe H, "Gastric carcinoma with lymphoid stroma. Its morphologic characteristics and prognostic correlations", Cancer, 38, pp.232~243 (1976)
- Luo Y, "Signaling pathways of EBVinduced oncogenesis", Cancer Cell Int, 21, pp.93~ (2021)
- Lim H, "Clinical application of early gastric carcinoma with lymphoid stroma based on lymph node metastasis status", Gastric Cancer, 20, pp.793~801 (2017)
- Shin DH, "Clinicopathologic features of early gastric carcinoma with lymphoid stroma and feasibility of endoscopic submucosal dissection", Surg Endosc, 31, pp.4156~4164 (2017)
- WHO Classification of Tumours Editorial Board, "Digestive system tumours" (2019), International Agency for Research on Cancer
- Fang WL, "Comparison of the clinicopathological characteristics and genetic alterations between patients with gastric cancer with or without Helicobacter pylori infection", Oncologist, 24, pp.e845~e853 (2019)
- Taghavi N, "p16INK4a hypermethylation and p53, p16 and MDM2 protein expression in esophageal squamous cell carcinoma", BMC Cancer, 10, pp.138~ (2010)