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EBV-Associated Gastric Cancer; An In Situ Hybridization Assay on Tissue Microarray: A Multi-Region Study from Four
Maryam Abolhasani1, Ata Ollah Mohseni2, Ramin Shakeri3
1Oncopathology Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Archives of Iranian Medicine
|April 30, 2024
Summary
Epstein-Barr virus (EBV) was found in 2.1% of gastric cancers in Iran, predominantly in younger patients and medullary types. This low prevalence suggests regional differences in risk factors for EBV-associated gastric cancer.
Area of Science:
- Oncology
- Virology
- Gastroenterology
Background:
- Gastric cancer is a significant global health concern, ranking as the fourth leading cause of cancer deaths worldwide.
- Identifying microbial agents like Epstein-Barr virus (EBV) in gastric cancer subtypes is crucial for targeted prevention and treatment strategies.
- Iran presents diverse gastric cancer incidence rates across its provinces, making it a relevant region for epidemiological studies.
Purpose of the Study:
- To determine the frequency of Epstein-Barr virus (EBV) infection in gastric cancers across four major Iranian provinces.
- To investigate the association between EBV infection and clinicopathological characteristics of gastric tumors in the Iranian population.
Main Methods:
- Analysis of 682 gastric cancer cases using paraffin-embedded tissue blocks from various Iranian regions.
- Construction of twelve tissue microarray (TMA) blocks for efficient sample analysis.
- In situ hybridization (ISH) for Epstein-Barr virus-encoded RNA (EBER) to detect EBV presence in tumor tissues.
- Statistical evaluation using the Chi-squared test to correlate EBV-associated gastric cancer (EBVaGC) with tumor characteristics.
Main Results:
- Epstein-Barr virus (EBV) was detected in 2.1% (14 out of 682) of gastric adenocarcinoma cases.
- A significantly higher prevalence of EBV was observed in medullary gastric carcinomas (36.4%) compared to non-medullary types (0.9%) (P<0.001).
- EBV-associated gastric cancers (EBVaGC) were more common in younger patients (P=0.009) and showed a trend towards lower tumor stage (P=0.075).
Conclusions:
- The prevalence of EBV-associated gastric adenocarcinoma in Iran is low.
- This low prevalence may be attributed to regional epidemiological variations in risk factors, exposures, and a lower incidence of gastric medullary carcinomas.
- Gastric tumor heterogeneity, potentially not fully captured by TMA techniques, might also influence the observed EBV prevalence.
