Is gastric lymphoepithelioma-like carcinoma a special subtype of EBV-associated gastric carcinoma? New insight based on clinicopathological features and EBV genome polymorphisms.
BACKGROUND
Gastric lymphoepithelioma-like carcinoma (LELC) is a rare entity that is closely associated with Epstein-Barr virus (EBV). However, the EBV latency pattern and genome polymorphisms in gastric LELC have not been systematically explored.


METHODS
The clinicopathological features, EBV latency pattern and genome polymorphisms of EBV-positive gastric LELC in Guangzhou, southern China were investigated and compared with those of ordinary EBV-associated gastric carcinoma (EBVaGC) in the same area.


RESULTS
Ten (1.42%) of 702 gastric carcinoma cases were identified as gastric LELC, in which eight (80%) cases were EBV-positive. The clinicopathological characteristics and EBV latency pattern of EBV-positive gastric LELC were similar to those of ordinary EBVaGC. In EBV genotype analysis, type A strain, type F, I, mut-W1/I, XhoI- and del-LMP1 variants were predominant among EBV-positive gastric LELCs, accounting for eight (100%), six (75%), eight (100%), seven (87.5%), five (62.5%) and six (75%) cases, respectively, which are similar to those in ordinary EBVaGC. For EBNA1 polymorphisms, the V-leu and P-ala subtypes were predominant in EBV-positive gastric LELC, which is different from the predominant V-val subtype in ordinary EBVaGC. EBV-positive gastric LELC has a favorable prognosis when compared to ordinary EBVaGC (median survival time 43.0 vs. 18.0 months).


CONCLUSIONS
Gastric LELC is strongly associated with EBV and EBV-positive gastric LELC should be regarded as a special subtype of EBVaGC. This, to our best knowledge, is the first time in the world that the EBV latency pattern and genome polymorphisms of EBV-positive gastric LELC are systematically revealed.
Department of Pathology, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, China.
Na
N
Cheng
Da-yang
DY
Hui
Yong
Y
Liu
Na-na
NN
Zhang
Ye
Y
Jiang
Jing
J
Han
Hai-Gang
HG
Li
Yun-Gang
YG
Ding
Hong
H
Du
Jian-Ning
JN
Chen
Chun-Kui
CK
Shao
D000230:Adenocarcinoma / Q000473:pathology / Q000821:virology*; D000328:Adult; D000368:Aged; D020031:Epstein-Barr Virus Infections / Q000235:genetics / Q000473:pathology / Q000821:virology*; D019309:Epstein-Barr Virus Nuclear Antigens / Q000235:genetics* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D004854:Herpesvirus 4, Human / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011110:Polymorphism, Genetic / Q000235:genetics*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000235:genetics / Q000473:pathology / Q000821:virology*; D015996:Survival Rate; D017735:Virus Latency
D019309:Epstein-Barr Virus Nuclear Antigens