Comprehensive characteristics of Epstein-Barr virus-associated early gastric cancer
Objective To analyze the clinical,endoscopic and pathological characteristics of Epstein-Barr virus(EBV)-associated early gastric cancer(EBVaEGC)and explore the risk factors associated with EBVaEGC.Methods Totally 247 patients diagnosed with early gastric cancer who underwent surgery or endoscopic submucosal dissection in Peking University Third Hospital from January 2010 to December 2022 were retrospectively enrolled.Patients were divided into EBVaEGC group and EBV-negative early gastric cancer(EBVnEGC)group according to the results of EBV-encoded small RNA in situ hybridization.The clinical,endoscopic and pathological characteristics of the two groups were compared.Univariate and multivariate Logistic regression analyses method were performed to assess the correlations between related characteristics and EBVaEGC.Results There were 25 cases of EBVaEGC and 222 cases of EBVnEGC.The proportions of abdominal pain and albumin＞40 g/L in the EBVaEGC group were lower than those in the EBVnEGC group,and the proportions of monocyte count and monocyte count＞0.33 × 109/L were higher than those in the EBVnEGC group(all P＜0.05).In terms of pathological features,the maximum tumor diameter in the EBVaEGC group was shorter than that in the EBVnEGC group,the maximum tumor diameter ≥1.5 cm and the proportion of background mucosal intestinalization were lower than those in the EBVnEGC group,and the proportion of lymphocyte infiltration or lymphoid follicle formation in the background mucosa was higher than that in the EBVnEGC group(all P＜0.05).Multivariate Logistic regression analysis indicated that albumin ≤40 g/L[odds ratio(OR)=3.367,95％confidence interval(CI):1.080-10.504,P=0.037],tumor maximum diameter＜1.5 cm(OR=4.582,95％CI:1.433-14.646,P=0.010),without intestinal metaplasia in the background mucosa(OR=6.032,95％CI:1.539-23.643,P=0.010),and the presence of massive lymphocyte infiltration or lymphoid follicle formation(OR=3.929,95％CI:1.247-12.380,P=0.019)were independent risk factors for EBVaEGC.Conclusions EBVaEGC exhibits distinct clinicopathological features.Patients with a relatively low preoperative albumin level,small tumor diameter,absence of obvious intestinal metaplasia in the background mucosa,and the presence of massive lymphocyte infiltration or lymphoid follicle formation may be indicative of EBVaEGC,and in situ hybridization should be performed to confirm the diagnosis of EBVaEGC.
Early gastric cancerEpstein-Barr virusClinicopathological characteristicsEndoscopic characteristics
万方数据
维普
