Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Room 6E582, 9609 Medical Center Drive, Rockville, MD, 20892-9776, USA.
Dig Dis Sci. 2021 Apr;66(4):1220-1226. doi: 10.1007/s10620-020-06288-1. Epub 2020 May 4.
Epstein-Barr virus (EBV) positivity is associated with better gastric cancer prognosis and is found in a relatively fixed 9% of tumors worldwide.
We aimed to examine the EBV status of gastric adenocarcinomas in a very high-incidence population and to compare prevalence between cardia and non-cardia anatomic subsites.
We evaluated 1035 adult gastric adenocarcinoma cases presenting during 1997-2005 to the Shanxi Cancer Hospital in Taiyuan, Shanxi Province, China. EBV-encoded RNA was detected in alcohol-fixed paraffin-embedded tumor specimens by in situ hybridization. Associations were assessed in case-case comparisons using the Chi-squared test for categorical variables and the Mann-Whitney U test for continuous variables, with p values < 0.05 considered statistically significant. Adjusted odds ratios were calculated using logistic regression, and mortality hazard ratios (HRs) were estimated by Cox proportional hazards regression.
Sixty-four percent of the evaluated cancers were found in the cardia. Cardia tumor localization was associated with male sex, advanced primary tumor stage, better differentiated histology, and intestinal-type Lauren classification. Four percent of the non-cardia and only 0.9% of cardia cancers were EBV-positive. EBV positivity was associated with better overall survival (adjusted HR 0.30, 95% CI 0.14-0.63).
Our study highlights unusually low EBV prevalence in gastric adenocarcinoma among a high-incidence population, particularly for cardia cancers. These findings suggest a unique risk factor profile for the high incidence of gastric cancer in this population.
EB 病毒（EBV）阳性与更好的胃癌预后相关，并且在全球相对固定的 9%的肿瘤中发现。
我们旨在检查高发人群中胃腺癌的 EBV 状态，并比较贲门和非贲门解剖部位的患病率。
我们评估了 1997-2005 年期间在中国山西省太原山西肿瘤医院就诊的 1035 例成年胃腺癌病例。通过原位杂交法检测酒精固定的石蜡包埋肿瘤标本中的 EBV 编码 RNA。使用卡方检验比较分类变量和 Mann-Whitney U 检验比较连续变量，p 值<0.05 被认为具有统计学意义。使用逻辑回归计算调整后的优势比，使用 Cox 比例风险回归估计死亡率危险比（HR）。
评估的癌症中有 64%发生在贲门。贲门肿瘤定位与男性、晚期原发性肿瘤分期、更好的分化组织学和肠型 Lauren 分类有关。非贲门肿瘤的 EBV 阳性率为 4%，而贲门肿瘤的 EBV 阳性率仅为 0.9%。EBV 阳性与更好的总生存相关（调整后的 HR 0.30，95%CI 0.14-0.63）。
我们的研究强调了高发人群中胃腺癌中 EBV 患病率异常低，尤其是贲门癌。这些发现表明该人群中胃癌高发有独特的危险因素特征。
