Nishikawa J, Yanai H, Hirano A, Okamoto T, Nakamura H, Matsusaki K, Kawano T, Miura O, Okita K
Microbiology and Tumorbiology Center, Karolinska Institute, Stockholm, Sweden.
Scand J Gastroenterol. 2002 Jul;37(7):825-9.
Epstein-Barr virus (EBV) has been detected in about 10% of gastric carcinoma cases worldwide, and a high prevalence of EBV involvement in gastric remnant carcinoma has been reported recently. Details of the background remnant stomach of EBV-positive lesions, however, have not been well clarified.
We screened 17 consecutive gastric remnant carcinoma lesions resected surgically. To detect EBV, we used in situ hybridization (ISH) for EBV-encoded small RNA1 (EBER-1) and we compared the clinicopathologic feature between EBV-positive and -negative gastric remnant carcinoma cases.
EBV was detected in 41.8% (7 of 17) of the lesions by EBER-1 ISH. All 7 EBV-positive lesions developed in the anastomotic site had undergone Billroth-II reconstruction excess 20 years previously (mean 26.4 years). Histologically, all EBV-positive lesions were poorly differentiated adenocarcinomas with intense lymphocyte infiltration. In the adjacent mucosa of carcinomas, moderate or marked intestinal metaplasia was found in 85.7% (6 of 7) of EBV-positive lesions and in 40% (4 of 10) of EBV-negative lesions.
EBV infection is strongly associated with gastric remnant carcinoma. Atrophic change of remnant gastritis in Billroth-II anastomoses is considered to be the carcinogenic background for EBV-positive gastric remnant carcinoma.
在全球约10%的胃癌病例中检测到爱泼斯坦-巴尔病毒（EBV），最近有报道称EBV在残胃癌中的感染率很高。然而，EBV阳性病变的残胃背景细节尚未完全阐明。
我们对17例连续手术切除的残胃癌病变进行了筛查。为了检测EBV，我们使用原位杂交（ISH）检测EBV编码的小RNA1（EBER-1），并比较了EBV阳性和阴性残胃癌病例的临床病理特征。
通过EBER-1 ISH在41.8%（17例中的7例）的病变中检测到EBV。所有7例EBV阳性病变均发生在吻合口部位，均在20多年前接受了毕Ⅱ式重建（平均26.4年）。组织学上，所有EBV阳性病变均为低分化腺癌，伴有强烈的淋巴细胞浸润。在癌旁黏膜中，85.7%（7例中的6例）的EBV阳性病变和40%（10例中的4例）的EBV阴性病变出现中度或重度肠化生。
EBV感染与残胃癌密切相关。毕Ⅱ式吻合术中残胃炎的萎缩性改变被认为是EBV阳性残胃癌的致癌背景。
