EB病毒相关胃癌地域分布特点及临床病理特征分析

Regional distribution and clinicopathological characteristics of Epstein-Barr virus associated gastric cancer

目的分析EB病毒相关胃癌(EBVaGC)的地域分布特点及临床病理特征。方法采用EB病毒编码的RNA(EBER)原位杂交染色方法,检测中国医学科学院肿瘤医院4081例手术切除胃腺癌标本中EBVaGC所占的比例,比较EBVaGC在不同地区的分布差异,并分析其与其他临床病理特征的关系。结果4081例胃腺癌中EBVaGC占3.0%(123/4081)。胃腺癌患者在90例以上的10个省、直辖市、自治区中,籍贯为吉林省的胃腺癌患者中EBVaGC所占比例最高,为7.6%,其后依次为辽宁省(5.4%)、安徽省(4.1%)、北京市(3.9%)、内蒙古自治区(3.7%)、山西省(3.4%)、黑龙江省(3.0%)、山东省(2.1%)、河北省(1.6%),而河南省的胃腺癌患者中未检测到EBVaGC病例,省、直辖市、自治区间差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,性别(0R=2.231,95%C/为1.290〜3.858)、WH0病理分型(OR=2.338,95%C/为2.051〜2.664)及N分期(OR=0.420,95%CI为0.284〜0.621)是EBVaGC的独立影响因素,男性、组织学类型为伴有淋巴间质的癌、淋巴结无转移的胃腺癌中EBVaGC所占比例更高,结论EBVaGC在不同地区的胃腺癌中分布存在差异,患者的性别、WHO病理分型和N分期与EBVaGC关系密切。

Objective To investigate regional distribution and clinicopathological features of Epstein-Barr virus associated gastric cancer(EBVaGC).Methods Epstein-Barr virus encoded RNA(KBER)was detected in 4081 cases of gastric adenocarcinoma in Cancer Hospital,Chinese Academy of Medical Sciences by using in situ hybridization.EBVaGCs were identified and their proportions in different provinces,autonomous regions and municipalities were compared.The correlation between EBVaGC and clinicopathological features was also analyzed.Results A total of 3.0%(123/4081)patients with gastric adenocarcinoma are EBVaGCs.Among the areas with cases more than 90,the highest proportion of EBVaGC was found in Jilin province,accounting for 7.6%,and then followed by 5.4%in Liaoning province,4.1%in Anhui province,3.9%in Beijing,3.7%in Inner Mongolia Autonomous Region,3.4%in Shanxi province,3.0%in Heilongjiang province,2.1%in Shandong province,1.6%in Hebei province,and no EBVaGC was found in Henan province.EBVaGC proportions are significantly different in these provinces,autonomous regions and municipalities(P<0.05).Multivariate analysis of logistic regression revealed that gender(OR=2.231,95%CI:1.290〜3.858),WHO classification(OR=2.338,95%CI:2.051〜2.664)ami Nstage(OR=0.420,95%CI:0.284〜0.621)were independent impact factors for EBVaGC.The proportion of EBVaGC was higher in males,gastric carcinomas accompanied with lymphoid stroma and patients without lymph node metastasis.Conclusions The proportion of EBVaGC in gastric adenocarcinoma displays area distribution disparity in China.The gender,WHO classification and Nstage are closely associated with EBVaGC.