Epstein-Barr Virus closely associated with Gastric Cancer: AGA

A new study conducted by Mayo Hirabayashi and colleagues showed that the Epstein-Barr virus (EBV) was connected to a significant fraction of stomach malignancies globally. The findings of this study were published in Clinical Gastroenterology and Hepatology.

Growing data suggests that the common gamma herpes virus, which frequently causes mononucleosis, may also play a role in the etiology of gastric cancer. Gastric cancer, the fourth most prevalent and lethal disease in the world, caused more than a million new cases and 770,000 fatalities in 2020.

According to evidence, the Epstein-Barr virus, a recognized carcinogen, may be the etiological cause of certain new occurrences of stomach cancer. This investigation was carried out in order to comprehensively investigate the percentage of EBV-positive stomach cancers.

Between January 1990 and August 2021, a systematic review (PROSPERO CRD42020164473) was carried out. The combined prevalence and associated 95% confidence intervals (CIs) of EBV in gastric tumors for the three subtypes of gastric adenocarcinoma—conventional lymphoepithelioma-like gastric carcinoma (LELC), adenocarcinoma, and remnant/stump carcinoma—were calculated for every nation and region for which data were available. Prevalence ratios (PRs) for sex, Lauren's categorization, gastric cancer stage, and anatomical location of the stomach were shown for conventional adenocarcinoma.

The key findings of this study were:

1. EBV prevalence in tumor cells was 7.5% in 220 studies that were eligible and included approximately 68 000 instances of conventional gastric adenocarcinoma.

2. It was greater in men than in women, in diffuse types compared to intestinal types, and in proximal regions compared to distal regions.

3. By stage of gastric cancer, there was no variation in EBV prevalence.

4. The frequency of EBV was 26.3% in remnant/stump cancer and 75.9% in LELC.

In conclusion, in the event that there is a causal link between EBV and stomach cancer, our data imply that primary preventive measures, such as the creation of a potent EBV vaccine, might save 81 000 instances of EBV-associated gastric cancer per year around the world.

Reference: 

Hirabayashi, M., Georges, D., Clifford, G. M., & de Martel, C. (2022). Estimating the global burden of Epstein-Barr virus associated gastric cancer: a systematic review and meta-analysis. In Clinical Gastroenterology and Hepatology. Elsevier BV. https://doi.org/10.1016/j.cgh.2022.07.042