Shen Hua, Zhong Meizuo, Wang Weili, Liao Ping, Yin Xianli, Rotroff Daniel, Knepper Todd C, Mcleod Howard L, Zhou Chengfang, Xie Shangchen, Li Wei, Xu Biaobo, He Yijing
Department of Oncology, Xiangya Hospital, Central South University, Changsha, China; Gastroenterology and Urology Department, Hunan Cancer hospital, Xiangya School of Medicine, Central South University, Changsha, China.
Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.
Clin Chim Acta. 2017 Aug;471:216-221. doi: 10.1016/j.cca.2017.06.006. Epub 2017 Jun 7.
Epstein-Barr virus (EBV) and microsatellite instability (MSI) are associated with the carcinogenesis of many kinds of tumors, including gastric cancer (GC). However, the impact of EBV and MSI status on the prognosis of stage II and III GC is still unclear. The aim of this study was to find out the prognostic value of EBV and MSI status in a population of GC patients from Southern China.
Patients were genotyped for EBV infection based on the detection of EBV DNA from the formalin-fixed paraffin-embedded (FFPE) specimens. Sequentially, MSI status was measured by direct sequencing. Clinical characteristics and overall survival (OS) were analyzed in 202 GC patients. Additionally, the association of EBV and MSI status with chemotherapy-based toxicity was analyzed in 324 GC patients.
The survival analysis revealed EBV+ patients had a poorer OS than EBV- patients (HR=1.75, 95% CI: 1.08-2.82, FDR p=0.04). This survival advantage for EBV- patients was also found in patients <60y (FDR p=0.04) and patient with stage III disease (FDR p=0.04).
EBV infection and MSI status are associated with overall survival of gastric cancer patients. However, traditional chemotherapy showed no difference on outcome of patients in EBV and MSI subgroups.
爱泼斯坦-巴尔病毒（EBV）和微卫星不稳定性（MSI）与多种肿瘤的发生相关，包括胃癌（GC）。然而，EBV和MSI状态对II期和III期GC患者预后的影响仍不清楚。本研究的目的是在来自中国南方的GC患者群体中找出EBV和MSI状态的预后价值。
基于从福尔马林固定石蜡包埋（FFPE）标本中检测EBV DNA对患者进行EBV感染基因分型。随后，通过直接测序测量MSI状态。对202例GC患者的临床特征和总生存期（OS）进行分析。此外，对324例GC患者分析EBV和MSI状态与基于化疗的毒性之间的关联。
生存分析显示EBV阳性患者的OS比EBV阴性患者差（HR=1.75，95%CI：1.08-2.82，FDR p=0.04）。在年龄<60岁的患者（FDR p=0.04）和III期疾病患者（FDR p=0.04）中也发现了EBV阴性患者的这种生存优势。
EBV感染和MSI状态与胃癌患者的总生存期相关。然而，传统化疗在EBV和MSI亚组患者的结局上没有差异。
