Epstein-Barr virus in gastric carcinoma with lymphoid stroma. Special reference to its detection by the polymerase chain reaction and in situ hybridization in 99 tumors, including a morphologic analysis.
BACKGROUND
Gastric carcinoma with lymphoid stroma (GCLS) has been reported to have a more favorable prognosis than ordinary gastric carcinoma, however, the precise mechanism of the pathogenesis for GCLS remains unclear.


METHODS
The authors analyzed 99 GCLS in 94 patients for Epstein-Barr virus (EBV) sequences using polymerase chain reaction (PCR) and in situ hybridization (ISH); these were compared with 42 ordinary gastric carcinomas.


RESULTS
Two series of PCR showed 81 (82%) and 46 (47%) of the 99 GCLS to have EBV sequences, which were significantly higher compared with ordinary gastric carcinoma (50% and 9.5%, respectively). With ISH using thymine-thymine dimerized oligonucleotide probes corresponding to EBV-encoded small RNA 1 (EBER1), 82 (83%) of 99 GCLS showed clear, intense hybridization signals localized over the nuclei of the tumor cells, in contrast to only 4 (9.5%) of 42 ordinary carcinomas (P < 0.001). A comparative morphologic analysis of EBER1-positive and negative GCLS revealed that typical features of GCLS, such as mild cellular pleomorphism, rare mitoses, a marked degree of lymphoid stroma, and mild fibrosis, together with a lymphoid infiltration within the cancer cell nests were significantly more frequent in EBER1-positive GCLS.


CONCLUSIONS
More than 80% of GCLS were associated with EBV. The presence of EBV association in GCLS was characterized by the above morphologic features.
Nakamura
S
S
Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Ueki
T
T
Yao
T
T
Ueyama
T
T
Tsuneyoshi
M
M
D000230:Adenocarcinoma / Q000382:microbiology / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000382:microbiology* / Q000473:pathology*; D002467:Cell Nucleus / Q000648:ultrastructure; D015342:DNA Probes; D004279:DNA, Viral / Q000032:analysis / Q000235:genetics; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D017403:In Situ Hybridization; D008221:Lymphoid Tissue / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008938:Mitosis; D016133:Polymerase Chain Reaction; D011379:Prognosis; D013274:Stomach Neoplasms / Q000382:microbiology* / Q000473:pathology*; D015996:Survival Rate
D015342:DNA Probes; D004279:DNA, Viral