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Evidence of Epstein-Barr Virus Association with Gastric Cancer and Non-Atrophic Gastritis
Virology and Cancer Research Unit, Federico Gomez Children's Hospital of Mexico, Dr. Marquez No.162, Col. Doctores, Cuauhtemoc, Mexico City D.F. 06720, Mexico
Graduate Program in Biological Sciences, National Autonomous University of Mexico (UNAM), Av. Universidad Nº 3000, Mexico City D.F. 04510, Mexico
Unit of Medical Research in Infectious and Parasitic Diseases (UIMEIP), Pediatric Hospital, 21st Century Medical Center, Social Security Mexican Institute (IMSS). Av. Cuauhtemoc 330, Col. Doctores, Cuauhtemoc, Mexico City D.F. 06720, Mexico
Oncology Hospital, 21st Century Medical Center, Social Security Mexican Institute (IMSS), Av. Cuauhtemoc 330, Col. Doctores, Cuauhtemoc, Mexico City D.F. 06720, Mexico
Merida's Medical Unit of High Specialty, Social Security Mexican Institute (IMSS), Merida, Yucatan, Mexico City D.F. 97150, Mexico
* Author to whom correspondence should be addressed.
Received: 26 August 2013; in revised form: 8 December 2013 / Accepted: 6 January 2014 / Published: 20 January 2014
Abstract: Different lines of evidence support an association between Epstein-Barr virus (EBV) and gastric cancer (GC). The main understood risk factor to develop GC is infection by Helicobacter pylori (H. pylori), which triggers a local inflammatory response critical for progression from gastritis to GC. The role of EBV in early inflammatory gastric lesions has been poorly studied. A recent study proposed a cutoff value of 2000 EBV particles to identify patients with increased chances of infection of the gastric epithelium, which may favor the inflammatory process. To better understand the role of EBV in cancer progression, we analyzed 75 samples of GC, 147 control samples of non-tumor gastric tissue derived from GC patients and 75 biopsies from patients with non-atrophic gastritis (NAG). A first-round PCR was used for EBV detection in tumor and non-tumor controls and a more sensitive nested PCR for gastritis samples; both PCRs had lower detection limits above the proposed cutoff value. With this strategy 10.67% of GC, 1.3% of non-tumor controls and 8% of gastritis samples were found positive. An EBER1 in situ hybridization showed EBV infection of epithelial cells in GC and in a third of NAG samples, while in the other NAGs infection was restricted to the mononuclear cell infiltrate. EBV-positive GCs were enriched in lace and cribriform patterns, while these rare patterns were not observed in EBV negative samples. Our results support a role for EBV in GC and early precursor lesions, either as directly oncogenic infecting epithelial cells or indirectly as an inflammatory trigger.
Keywords: Epstein-Barr virus; EBV; gastric cancer; non-atrophic gastritis; cribriform pattern and lace pattern
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Martínez-López, J.L.; Torres, J.; Camorlinga-Ponce, M.; Mantilla, A.; Leal, Y.A.; Fuentes-Pananá, E.M. Evidence of Epstein-Barr Virus Association with Gastric Cancer and Non-Atrophic Gastritis. Viruses 2014, 6, 301-318.
Martínez-López JL, Torres J, Camorlinga-Ponce M, Mantilla A, Leal YA, Fuentes-Pananá EM. Evidence of Epstein-Barr Virus Association with Gastric Cancer and Non-Atrophic Gastritis. Viruses. 2014; 6(1):301-318.
Martínez-López, Juan L.; Torres, Javier; Camorlinga-Ponce, Margarita; Mantilla, Alejandra; Leal, Yelda A.; Fuentes-Pananá, Ezequiel M. 2014. "Evidence of Epstein-Barr Virus Association with Gastric Cancer and Non-Atrophic Gastritis." Viruses 6, no. 1: 301-318.