https://observatorio.fm.usp.br/handle/OPI/40675
Title: | Epstein-Barr Virus Positive Gastric Cancer: A Distinct Subtype Candidate for Immunotherapy |
Authors: | PEREIRA, Marina Alessandra; BATISTA, Daniel Amadeus Molon; RAMOS, Marcus Fernando Kodama Pertille; CARDILI, Leonardo; RIBEIRO, Renan Ribeiro e; DIAS, Andre Roncon; ZILBERSTEIN, Bruno; RIBEIRO JR., Ulysses; CECCONELLO, Ivan; ALVES, Venancio Avancini Ferreira; MELLO, Evandro Sobroza de |
Citation: | JOURNAL OF SURGICAL RESEARCH, v.261, p.130-138, 2021 |
Abstract: | 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. |
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/24 Artigos e Materiais de Revistas Científicas - LIM/35 Artigos e Materiais de Revistas Científicas - ODS/03 |
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art_PEREIRA_EpsteinBarr_Virus_Positive_Gastric_Cancer_A_Distinct_Subtype_2021.PDF Restricted Access | publishedVersion (English) | 1.99 MB | Adobe PDF | View/Open Request a copy |
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