EBV associated gastric carcinomas (EBVaGC) accounts for 8-9% of all gastric cancer (GC) patients. All previous reports on EBVaGC were retrospective. The value of plasma EBV-DNA load in relation to EBVaGC is under researched.
From October 2014 to September 2017, we prospectively collected GC patients with EBER examination (N = 2,760) from Sun Yat-sen University Cancer Center. We compared the EBER status in paired biopsy and resection samples of 69 metastatic GC patients. The relationship between Helicobacter pylori (HP) infection and EBER was analyzed in 148 GC patients. Plasma EBV-DNA load was dynamic monitored in EBVaGC patients. All statistical analyses were performed using the Stata 13.0. All statistical tests were two-sided.
The incidence rate of EBVaGC in China was 5.07% (140/2760). EBVaGC patients were male predominant, younger, and had better histologic differentiation, earlier Tumor-Node-Metastasis stage than EBV negative GC (EBVnGC) patients. The 3-year survival was 76.84% (95% CI: 60.48-87.27%) vs 58.18% (95% CI: 55.89-60.39%) for EBVaGC and EBVnGC patients, P = 0.0001. Hp infection rate was 16.22% (23/148). There was no significant difference between EBVaGC (14.93%) and EBVnGC (17.28%) patients, P = 0.698. The consistent rate between biopsy and surgical resection samples was 98.6% (68/69). Only one patient was EBER negative in the biopsy and positive in the resection sample. The mean concentration of plasma EBV-DNA was 155.69 copies per milliliter in EBVnGC patients and 11109.6 copies per milliliter in EBVaGC patients, P < 0.001. Positive identifications of plasma EBV-DNA was associated with unfavorable prognosis. EBV-DNA load decreased when patients got PR/SD, while it increased when disease progressed.
This is the largest population prospective analysis of theclinicalpathological clinicopathological features and prognostic values of EBVaGC patients. The incidence rate of EBVaGC wais around 5%. Plasma EBV-DNA is a good marker in predicting recurrence and chemotherapy response for EBVaGC patients.
Clinical trial identification
Legal entity responsible for the study
Sun yat-sen University Cancer Center.
Has not received any funding.
The author has declared no conflicts of interest.