Risk for lymph node metastasis in Epstein–Barr virus‐associated gastric carcinoma with submucosal invasion

2020 ◽  
Author(s):  
Yosuke Tsuji ◽  
Tetsuo Ushiku ◽  
Tomohiro Shinozaki ◽  
Hiroharu Yamashita ◽  
Yasuyuki Seto ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Gastric Carcinoma ◽  
Epstein Barr Virus ◽  
Submucosal Invasion ◽  
Barr Virus ◽  
Node Metastasis ◽  
Epstein Barr

scholarly journals Epstein-Barr Virus-associated Gastric Carcinoma

2021 ◽  
Vol 21 (1) ◽  
pp. 22-28
Author(s):  
Bong Eun Lee
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Gastric Carcinoma ◽  
Epstein Barr Virus ◽  
The Cancer Genome Atlas ◽  
Molecular Characteristics ◽  
Barr Virus ◽  
Node Metastasis ◽  
Epstein Barr

Epstein-Barr virus-associated gastric carcinoma (EBVaGC) comprises approximately 10% of all gastric cancers and is now defined as one of the four subtypes of gastric cancer according to the molecular classification proposed by the Cancer Genome Atlas project. EBVaGC has characteristic genetic profiles that harbor a DNA methylation phenotype, frequent mutations in PIK3CA and ARID1A, and amplification of JAK2 and programmed death-ligand (PD-L)1/PD-L2. Therefore, EBVaGC shows several distinct clinicopathological features, including a male predominance, proximal stomach location, gastric carcinoma with lymphoid stroma histology, low risk of lymph node metastasis, and favorable prognosis. In clinical practice, patients with early EBVaGC might be good candidates for endoscopic resection or minimally invasive surgery since the rate of lymph node metastasis is very low, even with deep submucosal invasion. Furthermore, in the case of advanced EBVaGC, the applicability of immunotherapy has been investigated based on its increased expression of PD-L1 and high immunogenicity. In conclusion, EBV can serve as a biomarker in gastric cancer, and further identification of other molecular characteristics of EBVaGC is essential for new potential therapeutic targets.

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