Prognostic Implication of EBV Infection in Gastric Carcinomas: A Systematic Review and Meta-Analysis

• Published in: Medicina (Kaunas, Lithuania) Vol. 59; no. 5; p. 834
• Main Authors: Pyo, Jung-Soo, Kim, Nae-Yu, Kang, Dong-Wook
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 25-04-2023; MDPI
• Subjects: Bias; Cancer; Carcinoma; Classification; Comparative analysis; Epstein-Barr virus; Epstein-Barr Virus Infections - complications; Gastric cancer; gastric carcinoma; Health aspects; Herpesvirus 4, Human; Humans; Infection; Infections; Medical prognosis; Medical research; Medicine, Experimental; Meta-analysis; Microsatellite Instability; molecular classification; overall survival; Prognosis; Stomach cancer; Stomach Neoplasms - pathology; Survival analysis; meta-analysis; overall survival; gastric carcinoma; Epstein–Barr virus; molecular classification
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina59050834

This study aims to elucidate the prognostic implications of Epstein-Barr virus (EBV) infection in gastric carcinomas (GCs) through a systematic review and meta-analysis.
In total, 57 eligible studies and 22,943 patients were included in this meta-analysis. We compared the prognoses of EBV-infected and non-infected GC patients. The subgroup analysis was performed based on the study location, molecular classification, and Lauren's classification. This study was checked according to the PRISMA 2020. The meta-analysis was performed using the Comprehensive Meta-Analysis software package.
EBV infection was found in 10.4% (95% confidence interval (CI) 0.082-0.131) of GC patients. The EBV-infected GC patients had a better overall survival compared with the EBV-non-infected GC patients (hazard ratio (HR) 0.890, 95% CI 0.816-0.970). In the subgroup analysis based on molecular classification, no significant differences were found between EBV+ and microsatellite instability and microsatellite stable (MSS)/EBV- subgroups (HR 1.099, 95% CI 0.885-1.364 and HR 0.954, 95% CI 0.872-1.044, respectively). In the diffuse type of Lauren's classification, EBV-infected GCs have a better prognosis compared with the EBV-non-infected GCs (HR 0.400, 95% CI 0.300-0.534). The prognostic impact of EBV infection was found in the Asian and American subgroups but not in the European subgroup (HR 0.880, 95% CI 0.782-0.991, HR 0.840, 95% CI 0.750-0.941, and HR 0.915, 95% CI 0.814-1.028).
EBV infection is a favorable survival factor for GCs. However, the prognostic implications of EBV infection in the new molecular classification are not clear.