临床与病理杂志2025，Vol.45Issue(1)：1-8,8.DOI:10.11817/j.issn.2095-6959.2025.250014
EB病毒相关性胃癌的临床病理特征
Clinicopathological characteristics of Epstein-Barr virus-associated gastric cancer
摘要
Abstract
Objective:Gastric cancer exhibits significant tumor heterogeneity.Epstein-Barr virus-associated gastric cancer(EBVaGC)responds well to immune checkpoint inhibitor therapy and is associated with favorable prognosis.This study aims to explore the clinicopathological characteristics of EBVaGC to provide a reference for personalized immunotherapy in clinical practice. Methods:Twenty cases of EBVaGC were collected from the Affiliated Hospital of Nanjing University of Chinese Medicine/Jiangsu Province Hospital of Chinese Medicine and the People's Hospital of Dangtu County.A retrospective analysis was conducted on their general clinical characteristics,HE staining results,immunohistochemical staining results,and in-situ hybridization results for Epstein-Barr virus-encoded small RNA(EBER). Results:All 20 EBVaGC patients were male,with an average age of 60 years.Tumor diameters ranged from 1.0 to 9.5 cm,primarily presenting as ulcerative type,and were most commonly located in the cardia,fundus,and body of the stomach.HE staining showed a small number of intraepithelial neoplastic glands in the lamina propria,gradually forming anastomosing or branched structures in a"lace-like"pattern.Tumor cells gradually transitioned into poorly defined irregular clusters,sheets,trabeculae,or tubular structures,accompanied by prominent lymphocyte infiltration.Tumor cells were polygonal with indistinct borders,forming syncytial structures;nuclei were vacuolated with prominent nucleoli.Among 19 patients who underwent radical gastrectomy,none of the early-stage cases(1 patient at T1a and 4 patients at T1b)had lymph node metastasis,while 9 out of 14(64.28％)patients with advanced gastric cancer showed lymph node metastasis.In-situ hybridization showed diffuse EBER positivity in 18 patients,and in 2 patients,EBER was negative in tubular adenocarcinoma areas but positive in solid areas.Immunohistochemical staining showed all 20 patients retained positive expression of mismatch repair(MMR)proteins MLH1,PMS2,MSH2,and MSH6.None of the patients showed HER-2 positive expressed(3+). Conclusion:EBVaGC is not uncommon among gastric cancers and has a low risk of lymph node metastasis in early stages.Careful observation of histological morphology,combined with immunohistochemistry and EBER in-situ hybridization labeling,can enable accurate diagnosis.关键词
EB病毒相关性胃癌/临床病理特征/淋巴结转移/EBV编码的小RNA/免疫治疗Key words
Epstein-Barr virus-associated gastric cancer/clinicopathological characteristics/lymph node metastasis/Epstein-Barr virus-encoded small RNA/immunotherapy引用本文复制引用
梅静,刘永仙,芮军,赵明明,王珝,王耀辉..EB病毒相关性胃癌的临床病理特征[J].临床与病理杂志,2025,45(1):1-8,8.基金项目
江苏省卫生健康委员会医学科研项目(H2023098).This work was supported by the Medical Research Project of Jiangsu Commission of Health,China(H2023098). （H2023098）
