Epstein–Barr Virus Positive Gastric Cancer: A Distinct Subtype Candidate for Immunotherapy
| Autor: | Renan Ribeiro e Ribeiro, Ivan Cecconello, Evandro Sobroza de Mello, Bruno Zilberstein, Venâncio Avancini Ferreira Alves, Marina Alessandra Pereira, Marcus Fernando Kodama Pertille Ramos, Leonardo Cardili, Andre Roncon Dias, Ulysses Ribeiro, Daniel Amadeus Molon Batista |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Epstein-Barr Virus Infections Herpesvirus 4 Human medicine.medical_specialty medicine.medical_treatment medicine.disease_cause Gastroenterology B7-H1 Antigen 03 medical and health sciences Lymphocytes Tumor-Infiltrating 0302 clinical medicine Stomach Neoplasms Internal medicine medicine Humans Aged Retrospective Studies Aged 80 and over business.industry Carcinoma Cancer Epstein-Barr Virus Positive Immunotherapy Middle Aged medicine.disease Epstein–Barr virus Medullary carcinoma 030220 oncology & carcinogenesis Immunohistochemistry Female 030211 gastroenterology & hepatology Surgery business Gastric Carcinoma with Lymphoid Stroma CD8 |
| Zdroj: | Journal of Surgical Research. 261:130-138 |
| ISSN: | 0022-4804 |
| Popis: | Background Epstein–Barr virus (EBV) positive gastric cancer (GC) has been described as a distinct molecular subtype of the disease, especially associated with gastric carcinoma with lymphoid stroma (GCLS). The possibility that EBV associated GC (EBVaGC) had better prognosis and may be susceptible to immunotherapy has increased the interest in this subtype. However, immune checkpoint and survival of EBVaGC are still controversial, especially with regard to GCLS and conventional gastric adenocarcinoma (CGA). This study aimed to evaluate the clinicopathological characteristics, immunohistochemical profiles and prognosis of EBVaGC according to the histological type GCLS and CGA. Methods we retrospectively evaluated a series of EBVaGC who underwent gastrectomy with D2-lymphadenectomy. Biomarkers and tumor-infiltrating cells were evaluated by immunohistochemistry. PD-L1 was evaluated using a combined positive score (CPS). Results From a total of 30 EBVaGC, 14 (46.7%) were identified as GCLS and 16 (53.3%) as CGA (9 Intestinal, 6 diffuse, 1 undetermined). There were no significant differences in age, sex, and pTNM between GCLS and CGA. CPS-positivity and high-CD8+ was significantly higher in GCLS compared with CGA (P = 0.007 and P = 0.005, respectively). Diffuse EBVaGC had worse survival than intestinal type (P = 0.020). There was no difference in survival between GCLS and intestinal CGA (P = 0.260). In multivariate analysis, CPS and pN status were related with survival in EBVaGC. Conclusions CGLS was associated with a predominance of CD8+ cell infiltration and PD-L1 expression. CPS and lymph node metastasis were independent factors associated with prognosis in EBVaGC. These results suggest that specifically EBV-positive GCLS may be prime candidates for PD-1 directed therapy. |
| Databáze: | OpenAIRE |
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