Division of Medical Oncology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, USA.
Division of Hematology/Oncology, Department of Medicine, St. Michael's Hospital, University of Toronto, Canada.
Cancer Treat Rev. 2018 May;66:15-22. doi: 10.1016/j.ctrv.2018.03.006. Epub 2018 Mar 31.
Epstein-Barr virus associated gastric cancer (EBVaGC) comprises approximately 10% of gastric carcinomas. Multiple factors contribute to tumorigenesis, including EBV driven hypermethylation of tumor suppressor genes, inflammatory changes in gastric mucosa, host immune evasion by EBV and changes in cell cycle pathways. The unique molecular characteristics of EBVaGC, such as programmed death ligand 1 (PD-L1) overexpression, highlight the potential for using EBV as a biomarker for response to immunotherapy. Few studies have reported benefit from immunotherapy in EBV positive cancers, and clinical trials investigating the impact of checkpoint inhibitors in EBVaGC are currently underway. This review provides the most recent updates on molecular pathophysiology, epidemiology, clinical features and treatment advances pertaining to EBVaGC.
EB 病毒相关胃癌（EBVaGC）约占胃癌的 10%。多种因素导致肿瘤发生，包括 EBV 驱动的肿瘤抑制基因异常甲基化、胃黏膜炎症改变、EBV 引起的宿主免疫逃逸以及细胞周期通路改变。EBVaGC 的独特分子特征，如程序性死亡配体 1（PD-L1）过表达，提示 EBV 作为免疫治疗反应生物标志物的潜力。少数研究报告 EBV 阳性癌症从免疫治疗中获益，目前正在进行临床试验以研究检查点抑制剂对 EBVaGC 的影响。本文就 EBVaGC 的分子病理生理学、流行病学、临床特征和治疗进展的最新研究进行综述。
