Kayamba Violet, Monze Mwaka, Asombang Akwi Wasi, Zyambo Kanekwa, Kelly Paul
Tropical Gastroenterology & Nutrition Group, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia.
University Teaching Hospital, Nationalist Road, Lusaka, Zambia.
Pan Afr Med J. 2016 Feb 18;23:45. doi: 10.11604/pamj.2016.23.45.8503. eCollection 2016.
Gastric cancer is one of the major causes of cancer related deaths, but data from sub-Saharan Africa are very scanty. The cancer genome atlas (TCGA) initiative confirmed Epstein-Barr virus (EBV) related cancer as a distinct subtype, and we set out to look for serological evidence of its role in a sub-Saharan African patient group.
We used stored serum samples obtained from a gastric cancer case-control study conducted between 2010 and 2012 in Lusaka, Zambia. A total of 147 patients were included with 51 gastric adenocarcinoma cases and 96 age and sex matched controls. The presence of antibodies to EBV nuclear antigen-1 (EBNA-1) and early antigen (EA) was determined using commercially available ELISA kits. Data were analysed in STATA Stata Corp, College Station TX.
Over 90% of all the samples analysed were positive for antibodies to EBNA-1. The presence of antibodies to EBV EA was significantly higher in gastric cancer cases than in controls, (OR 4.38; 95% CI 1.53-13.06, P = 0.0027), with an attributable risk of 23%. HIV infection was also associated with EBV EA seroprevalence (OR 10.97; 95% CI 2.26 -13.06, P = 0.001) but not EBNA-1 (OR 0.81; 95% CI 0.10 -38.75, P = 0.596). There was no association of EBV infection with age below 45 years, Helicobacter pylori infection, intestinal metaplasia, gastric atrophy or inflammation.
We therefore conclude that EBV exposure is common among Zambian adults and that EBV EA seropositivity is associated with gastric cancer and HIV infection, but not premalignant lesions.
胃癌是癌症相关死亡的主要原因之一，但撒哈拉以南非洲地区的数据非常匮乏。癌症基因组图谱（TCGA）计划证实了爱泼斯坦-巴尔病毒（EBV）相关癌症是一种独特的亚型，我们着手寻找其在撒哈拉以南非洲患者群体中作用的血清学证据。
我们使用了2010年至2012年在赞比亚卢萨卡进行的一项胃癌病例对照研究中收集的储存血清样本。共纳入147名患者，其中51例胃腺癌病例和96例年龄及性别匹配的对照。使用市售酶联免疫吸附测定（ELISA）试剂盒测定抗EBV核抗原-1（EBNA-1）和早期抗原（EA）抗体的存在情况。数据在德克萨斯州大学城的Stata公司的STATA软件中进行分析。
所有分析样本中超过90%的抗EBNA-1抗体呈阳性。胃癌病例中抗EBV EA抗体的存在显著高于对照组（比值比4.38；95%置信区间1.53 - 13.06，P = 0.0027），归因风险为23%。HIV感染也与EBV EA血清阳性率相关（比值比10.97；95%置信区间2.26 - 13.06，P = 0.001），但与EBNA-1无关（比值比0.81；95%置信区间0.10 - 38.75，P = 0.596）。EBV感染与45岁以下年龄、幽门螺杆菌感染、肠化生、胃萎缩或炎症无关。
因此，我们得出结论，赞比亚成年人中EBV暴露很常见，EBV EA血清阳性与胃癌和HIV感染相关，但与癌前病变无关。
