Clinicopathological features of Epstein-Barr virus-associated gastric carcinoma: A systematic review and...

The purpose of this meta-analysis was to explore the clinicopathological characteristics of Epstein-Barr virus (EBV)-associated gastric carcinoma (AGC) based on qualified studies.

PubMed, Cochrane and Embase databases updated to November 2017 were searched by the index words to identify relevant studies, including qualified randomized controlled trials, cohort studies or case-control studies. Studies were also identified by tracking reference lists. The meta-analysis included relative risks (RR), mean difference (MD) along with 95% confidence interval (95% CI) to analyze the main outcomes.

A total of 35 studies were included in this meta-analysis with 7540 cases and 950 Epstein-Barr virus associated gastric cancer (EBVaGC) cases. The results indicated the EBV infection rate was significantly higher in males than in females (OR, 0.42; 95%CI 0.35-0.52), and the EBV infection rate was significantly higher in the diffuse type than in intestinal type (OR, 1.56; 95%CI 1.24-1.97). Besides, there was no marked association of EBV infection rate with lymph node metastasis (OR, 0.73; 95%CI 0.41-1.29), age (OR, 0.78; 95%CI 0.61-1.00) and pathologic tumor stage (OR, 1.11; 95%CI 0.90-1.38). The results of funnel plot, Begg's and Mazumdar's rank test, and Egger's test all showed no significant publication bias.

In this meta-analysis, EBV infection rate was significantly higher in males and in diffuse cancer type. However, there was no marked association with lymph node metastasis, age and pathologic tumor stage. Thus, EBV-positive gastric cancer has distinct clinicopathological features.