https://observatorio.fm.usp.br/handle/OPI/28128
Title: | Clinicopathological and prognostic features of Epstein-Barr virus infection, microsatellite instability, and PD-L1 expression in gastric cancer |
Authors: | PEREIRA, Marina A.; RAMOS, Marcus F. K. P.; FARAJ, Sheila F.; DIAS, Andre R.; YAGI, Osmar K.; ZILBERSTEIN, Bruno; CECCONELLO, Ivan; ALVES, Venancio A. F.; MELLO, Evandro S. de; RIBEIRO JR., Ulysses |
Citation: | JOURNAL OF SURGICAL ONCOLOGY, v.117, n.5, Special Issue, p.829-839, 2018 |
Abstract: | Background and ObjectivesGastric cancer (GC) has recently been categorized in molecular subtypes, which include Epstein-Barr (EBV)-positive and microsatellite instability (MSI) tumors. This distinction may provide prognostic information and identifies therapeutic targets. The aim of this study was to evaluate EBV, MSI, and PD-L1 immunoexpression in GC and its relationship with clinicopathological characteristics and patient's prognosis. MethodsWe evaluated 287 GC patients who underwent D2-gastrectomy through immunohistochemistry for DNA mismatch repair proteins and PD-L1, and in situ hybridization for EBV detection utilizing tissue microarray. ResultsEBV-positive and MSI were identified in 10.5% and 27% of the GCs, respectively. EBV positivity was associated to male gender (P=0.032), proximal location (P<0.001), undetermined Lauren type (P<0.001), poorly differentiated histology (P=0.043) and severe inflammatory infiltrate (P<0.001). MSI-tumors were associated to older age (P=0.002), subtotal gastrectomy (P=0.004), pN0 (P=0.024) and earlier TNM stage (P=0.020). PD-L1-positive was seen in 8.8% of cases, with predominant expression in EBV-positive GC (P<0.001). MSI was associated to better survival outcomes. ConclusionEBV-positive GCs had increased PD-L1 expression, while MSI GC had better survival outcome. EBV and MSI subgroups are distinct GC entities, their recognition is feasible by conventional techniques, and it may help individualize follow-up and guide adjuvant therapy. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MGT Artigos e Materiais de Revistas Científicas - FM/MPT Artigos e Materiais de Revistas Científicas - HC/ICESP Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - LIM/14 Artigos e Materiais de Revistas Científicas - LIM/35 Artigos e Materiais de Revistas Científicas - LIM/37 Artigos e Materiais de Revistas Científicas - LIM/38 Artigos e Materiais de Revistas Científicas - ODS/03 |
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art_PEREIRA_Clinicopathological_and_prognostic_features_of_EpsteinBarr_virus_infection_2018.PDF Restricted Access | publishedVersion (English) | 972.16 kB | Adobe PDF | View/Open Request a copy |
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