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Host inflammatory response predicts survival of patients with Epstein-Barr virus-associated gastric carcinoma

  • 0Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea.
Gastroenterology +

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April 20, 2010

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April 20, 2010

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Summary

This summary is machine-generated.

The survival advantage in Epstein-Barr virus-associated gastric carcinoma (EBV-GC) depends on the host's immune response, not just EBV infection. Lymphoepithelioma-like carcinoma (LELC) and LELC with Crohn's disease-like lymphocytic reaction (CLR) show better prognoses.

Area Of Science

  • Oncology
  • Virology
  • Immunology

Background

  • Lymphoepithelioma-like carcinoma (LELC) is a rare gastric carcinoma (GC) subtype with a favorable prognosis.
  • Most LELC cases are linked to Epstein-Barr virus (EBV) infection.
  • The study investigates if the improved survival in LELC is due to EBV or the associated immune response.

Purpose Of The Study

  • To determine the factors contributing to the survival advantage in EBV-associated gastric carcinoma (EBV-GC).
  • To differentiate the impact of EBV infection versus host inflammatory responses on GC prognosis.
  • To evaluate the prognostic significance of different histologic subtypes of EBV-GC.

Main Methods

  • Compared 123 EBV-associated GCs (1994-2008) with 405 EBV-negative GCs.
  • Subclassified EBV-associated GCs into LELC, Crohn's disease-like lymphocytic reaction (CLR), and conventional adenocarcinoma based on immune response patterns.
  • Utilized univariate and multivariate analyses with Bonferroni correction for statistical comparison.

Main Results

  • EBV-associated GC patients were older and had tumors in proximal locations with lower N and T stages.
  • Univariate analysis showed longer survival for EBV-associated GC, but this was not significant in multivariate analysis.
  • LELC and EBV-GC with CLR demonstrated significantly longer overall and disease-free survival compared to other subtypes.

Conclusions

  • The prognosis of EBV-associated GC is significantly influenced by the host's inflammatory immune response.
  • The definition of LELC should be broadened to encompass EBV-associated GCs exhibiting CLR, given their similar favorable outcomes.
  • Host immune response patterns are critical determinants of survival in EBV-associated gastric cancers.

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