Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE
Yong Chan Lee |
Professor of Medicine Director, Gastrointestinal Research Laboratory Veterans Affairs Medical Center, Univ. California San Francisco San Francisco, USA |
Jong Pil Im | Seoul National University College of Medicine, Seoul, Korea |
Robert S. Bresalier | University of Texas M. D. Anderson Cancer Center, Houston, USA |
Steven H. Itzkowitz | Mount Sinai Medical Center, NY, USA |
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Jin Hee Noh1 , Jun Young Shin2
, Jeong Hoon Lee1
, Young Soo Park2
, In-Seob Lee3
, Ga Hee Kim4
, Hee Kyong Na1
, Ji Yong Ahn1
, Kee Wook Jung1
, Do Hoon Kim1
, Kee Don Choi1
, Ho June Song1
, Gin Hyug Lee1
, and Hwoon-Yong Jung1
Correspondence to:Jeong Hoon Lee
ORCID https://orcid.org/0000-0002-0778-7585
E-mail jhlee.gi@amc.seoul.kr
Young Soo Park
ORCID https://orcid.org/0000-0001-5389-4245
E-mail youngspark@amc.seoul.kr
Jin Hee Noh and Jun Young Shin contributed equally to this work as first authors.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Gut Liver
Published online May 25, 2022
Copyright © Gut and Liver.
Background/Aims: Epstein-Barr virus (EBV) and Helicobacter pylori (HP) coinfection may synergistically induce severe inflammatory responses in the stomach tissue, increasing the risk of developing gastric cancer. We aimed to analyze the effect of EBV and HP coinfection on the clinicopathologic features and prognosis of gastric cancer, as well as to evaluate the role of EBV infection in non-gastric carcinoma with lymphoid stroma (non-GCLS).
Methods: Overall, 956 patients who underwent surgery for gastric cancer between September 2014 and August 2015 were eligible and divided into groups, according to GCLS morphology, EBV infection, and HP infection. Clinicopathologic characteristics and oncologic outcomes were analyzed retrospectively.
Results: EBV and HP coinfection was significantly associated with male sex, proximal location, GCLS morphology, and equivocal p53 expression (p<0.001). Multivariate analysis revealed that EBV infection alone (hazard ratio [HR], 0.362; 95% CI, 0.131 to 0.996; p=0.049) and lower third location (HR, 0.624; 95% CI, 0.413 to 0.943; p=0.025) were inversely correlated with overall survival. During median follow-up period of 72 months, overall survival rate was not significantly different between the EBV and HP coinfection group and others (97.6% vs 86.8%; log-rank p=0.144). In non-GCLS patients (n=920), overall survival rate was not significantly different between the EBV infection group and others (96.9% vs 86.4%; log-rank p=0.126).
Conclusions: EBV and HP coinfection is not an independent prognostic factor for gastric cancer. EBV infection status, regardless of HP infection, affects the clinicopathologic features of all types of gastric cancer. However, it does not lead to a significant difference in overall survival of non-GCLS patients.
Keywords: Coinfection, Gastric cancer, Gastric carcinoma with lymphoid stroma, Prognosis
Gut and Liver
Published online May 25, 2022
Copyright © Gut and Liver.
Jin Hee Noh1 , Jun Young Shin2
, Jeong Hoon Lee1
, Young Soo Park2
, In-Seob Lee3
, Ga Hee Kim4
, Hee Kyong Na1
, Ji Yong Ahn1
, Kee Wook Jung1
, Do Hoon Kim1
, Kee Don Choi1
, Ho June Song1
, Gin Hyug Lee1
, and Hwoon-Yong Jung1
Departments of 1Gastroenterology, 2Pathology, and 3Surgery, Asan Medical Center, University of Ulsan College of Medicine, and 4Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
Correspondence to:Jeong Hoon Lee
ORCID https://orcid.org/0000-0002-0778-7585
E-mail jhlee.gi@amc.seoul.kr
Young Soo Park
ORCID https://orcid.org/0000-0001-5389-4245
E-mail youngspark@amc.seoul.kr
Jin Hee Noh and Jun Young Shin contributed equally to this work as first authors.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background/Aims: Epstein-Barr virus (EBV) and Helicobacter pylori (HP) coinfection may synergistically induce severe inflammatory responses in the stomach tissue, increasing the risk of developing gastric cancer. We aimed to analyze the effect of EBV and HP coinfection on the clinicopathologic features and prognosis of gastric cancer, as well as to evaluate the role of EBV infection in non-gastric carcinoma with lymphoid stroma (non-GCLS).
Methods: Overall, 956 patients who underwent surgery for gastric cancer between September 2014 and August 2015 were eligible and divided into groups, according to GCLS morphology, EBV infection, and HP infection. Clinicopathologic characteristics and oncologic outcomes were analyzed retrospectively.
Results: EBV and HP coinfection was significantly associated with male sex, proximal location, GCLS morphology, and equivocal p53 expression (p<0.001). Multivariate analysis revealed that EBV infection alone (hazard ratio [HR], 0.362; 95% CI, 0.131 to 0.996; p=0.049) and lower third location (HR, 0.624; 95% CI, 0.413 to 0.943; p=0.025) were inversely correlated with overall survival. During median follow-up period of 72 months, overall survival rate was not significantly different between the EBV and HP coinfection group and others (97.6% vs 86.8%; log-rank p=0.144). In non-GCLS patients (n=920), overall survival rate was not significantly different between the EBV infection group and others (96.9% vs 86.4%; log-rank p=0.126).
Conclusions: EBV and HP coinfection is not an independent prognostic factor for gastric cancer. EBV infection status, regardless of HP infection, affects the clinicopathologic features of all types of gastric cancer. However, it does not lead to a significant difference in overall survival of non-GCLS patients.
Keywords: Coinfection, Gastric cancer, Gastric carcinoma with lymphoid stroma, Prognosis