Epstein–Barr virus positivity, not mismatch repair-deficiency, is a favorable risk factor for lymph node metastasis in submucosa-invasive early gastric cancer View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2015-11-16

AUTHORS

Ji Hye Park, Eun Kyung Kim, Yon Hee Kim, Jie-Hyun Kim, Yoon Sung Bae, Yong Chan Lee, Jae-Ho Cheong, Sung Hoon Noh, Hyunki Kim

ABSTRACT

BackgroundEpstein–Barr virus (EBV)-associated gastric cancer (GC) and microsatellite-instability-high GC are associated with a low prevalence of regional lymph node metastasis (LNM). To evaluate the feasibility of endoscopic treatment of EBV-associated and/or microsatellite-instability-high early GC (EGC), we analyzed the risk factors for LNM using a large series (n = 756) of submucosa-invasive (SM) EGC.MethodsEBV-encoded RNA in situ hybridization (EBER ISH) and immunohistochemistry for four mismatch repair (MMR) proteins (MLH1, PMS2, MSH2, and MSH6) were performed. The clinicopathologic features and results of EBER ISH and immunohistochemistry were compared according to the LNM status.ResultsAmong the cases, 146 EGCs (19.3 %) showed LNM. EBV negativity, larger tumor size (greater than 2 cm), deeper level of submucosal invasion, submucosal invasion depth greater than 500 µm, presence of ulceration, and presence of lymphovascular invasion (LVI) were associated with LNM. However, the MMR deficiency was not correlated with LNM. On multivariate regression analysis, larger tumor size (greater than 2 cm; odds ratio 1.6, p = 0.030), deeper level of submucosal invasion (odds ratio 2.9, p = 0.001), LVI (odds ratio 7.4, p < 0.001), and EBV negativity (p = 0.020) were independent risk factors for LNM in SM EGCs.ConclusionsEBV positivity was a favorable risk factor for LNM in SM EGC. However, MMR deficiency was not associated with the status of LNM. Thus, we suggest that examination with EBER ISH could be considered for endoscopic resected specimens, especially in cases of SM EGC showing no LVI and clear resection margins. More... »

PAGES

1041-1051

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10120-015-0565-1

DOI

http://dx.doi.org/10.1007/s10120-015-0565-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1045541400

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26573601


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41 schema:description BackgroundEpstein–Barr virus (EBV)-associated gastric cancer (GC) and microsatellite-instability-high GC are associated with a low prevalence of regional lymph node metastasis (LNM). To evaluate the feasibility of endoscopic treatment of EBV-associated and/or microsatellite-instability-high early GC (EGC), we analyzed the risk factors for LNM using a large series (n = 756) of submucosa-invasive (SM) EGC.MethodsEBV-encoded RNA in situ hybridization (EBER ISH) and immunohistochemistry for four mismatch repair (MMR) proteins (MLH1, PMS2, MSH2, and MSH6) were performed. The clinicopathologic features and results of EBER ISH and immunohistochemistry were compared according to the LNM status.ResultsAmong the cases, 146 EGCs (19.3 %) showed LNM. EBV negativity, larger tumor size (greater than 2 cm), deeper level of submucosal invasion, submucosal invasion depth greater than 500 µm, presence of ulceration, and presence of lymphovascular invasion (LVI) were associated with LNM. However, the MMR deficiency was not correlated with LNM. On multivariate regression analysis, larger tumor size (greater than 2 cm; odds ratio 1.6, p = 0.030), deeper level of submucosal invasion (odds ratio 2.9, p = 0.001), LVI (odds ratio 7.4, p < 0.001), and EBV negativity (p = 0.020) were independent risk factors for LNM in SM EGCs.ConclusionsEBV positivity was a favorable risk factor for LNM in SM EGC. However, MMR deficiency was not associated with the status of LNM. Thus, we suggest that examination with EBER ISH could be considered for endoscopic resected specimens, especially in cases of SM EGC showing no LVI and clear resection margins.
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48 schema:keywords BackgroundEpstein–Barr virus
49 ConclusionsEBV positivity
50 EBER ISH
51 EBV
52 EBV negativity
53 Epstein-Barr virus positivity
54 ISH
55 LNM status
56 MMR deficiency
57 MethodsEBV
58 RNA
59 ResultsAmong
60 SM EGC
61 analysis
62 cancer
63 cases
64 clear resection margins
65 clinicopathologic
66 deep levels
67 deficiency
68 depth
69 early GC
70 early gastric cancer
71 endoscopic treatment
72 examination
73 factors
74 favorable risk factors
75 feasibility
76 gastric cancer
77 high GC
78 high early GC
79 hybridization
80 immunohistochemistry
81 independent risk factor
82 invasion
83 invasion depth
84 large series
85 larger tumor size
86 levels
87 low prevalence
88 lymph node metastasis
89 lymphovascular invasion
90 margin
91 metastasis
92 mismatch
93 mismatch repair proteins
94 multivariate regression analysis
95 negativity
96 node metastasis
97 positivity
98 presence
99 presence of ulceration
100 prevalence
101 protein
102 regional lymph node metastasis
103 regression analysis
104 repair proteins
105 resection margins
106 results
107 risk factors
108 series
109 situ hybridization
110 size
111 specimens
112 status
113 status of LNM
114 submucosa-invasive (SM) EGC
115 submucosa-invasive early gastric cancer
116 submucosal invasion
117 submucosal invasion depth
118 treatment
119 tumor size
120 ulceration
121 virus
122 virus positivity
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