title: Epstein-Barr virus is associated with gastric carcinoma: the question is what is the significance?
abstract: OBJECTIVE
  To examine the possible role of the Epstein-Barr Virus (EBV) in the development of gastric adenocarcinoma (GC). It is unclear whether EBV is involved in GC development or is a consequence of gastric inflammation secondary to immunosuppressive treatments.
  
  
  METHODS
  A systematic review was carried out of all published observational studies on the temporal association between EBV and GC, with a view to determine a causal relationship.
  
  
  RESULTS
  The present study showed that the worldwide crude prevalence of EBV in gastric adenocarcinoma was 8.29%. The prevalence varied from 7.08% for intestinal type and 9.82% for diffuse type of GC. It was observed that Western and Central Asian countries had a significantly higher frequency of EBV positive cases compared to South-Eastern countries. America had the highest EBV-GC prevalence whereas Europe had the lowest.
  
  
  CONCLUSIONS
  The present review has demonstrated a high prevalence of EBV in gastric adenocarcinoma. However, studies designed to assess a temporal relationship and histological association using sensitive techniques should be carried out to establish the role of EBV in GC carcinogenesis.
authors.affiliation: Molecular Oncology Group and Molecular Virology Laboratory, Portuguese Institute of Oncology of Porto, Porto 4200-072, Portugal.
authors.forename: Hugo
authors.initials: H
authors.lastname: Sousa
authors.forename: Ana-L
authors.initials: AL
authors.lastname: Pinto-Correia
authors.forename: Rui
authors.initials: R
authors.lastname: Medeiros
authors.forename: Mario
authors.initials: M
authors.lastname: Dinis-Ribeiro
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology* / Q000821:virology*; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000473:pathology; D014943:Global Health; D004854:Herpesvirus 4, Human / Q000378:metabolism*; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D007249:Inflammation; D008495:Medical Oncology / Q000379:methods; D015995:Prevalence; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000821:virology*; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents