Endoscopic and pathologic features of Epstein-Barr virus-associated gastric carcinoma.
BACKGROUND
Although the presence of Epstein-Barr virus has been documented in approximately 7% of patients with gastric carcinoma, the clinical features of Epstein-Barr virus-associated carcinoma have not been well documented. We studied the histologic and endoscopic characteristics of Epstein-Barr virus-associated gastric carcinoma.


METHODS
We tested 124 gastric carcinomas from 117 patients using in situ hybridization for Epstein-Barr virus encoded small RNA1. The histologic and endoscopic findings in the Epstein-Barr virus-associated groups and the negative control groups were analyzed and compared.


RESULTS
Twelve tumors (9.7%) were identified as Epstein-Barr virus associated. These lesions were located mainly in the upper part of the stomach (p < .05) and had a diffuse-type histology (p < .05) compared with those in the control group. Six of seven (85.7%) early Epstein-Barr virus-associated lesions were type 0 IIc (superficial depressed) or a combined type, and 42.9% were accompanied by submucosal nodules of carcinoma with lymphoid stroma. Four of five (80%) advanced Epstein-Barr virus-associated tumors were type 3 (ulcerated without definite limits), thought to be the advanced shape of superficial depressed lesions.


CONCLUSIONS
Epstein-Barr virus-associated gastric carcinomas often appear as superficial depressed or ulcerated lesions in the upper part of the stomach and have a diffuse-type histology with lymphoid infiltration.
Yanai
H
H
First Department of Internal Medicine, Tokyo Medical and Dental University, Japan.
Nishikawa
J
J
Mizugaki
Y
Y
Shimizu
N
N
Takada
K
K
Matsusaki
K
K
Toda
T
T
Matsumoto
Y
Y
Tada
M
M
Okita
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery / Q000821:virology; D005260:Female; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000473:pathology; D005773:Gastroscopy; D006566:Herpesviridae Infections / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D004854:Herpesvirus 4, Human / Q000235:genetics; D006801:Humans; D017403:In Situ Hybridization; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012367:RNA, Viral / Q000032:analysis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery / Q000821:virology; D014412:Tumor Virus Infections / Q000209:etiology / Q000473:pathology* / Q000601:surgery
D015415:Biomarkers; C099537:Epstein-Barr virus encoded RNA 1; D012367:RNA, Viral