Rate of Epstein-Barr Virus in Gastric Adenocarcinoma in Egyptian Patients in View of the WHO Classification and Correlation with p16 Immunoreactivity

Safia Samir; Hend Okasha Ahmed; Tarek M. Diab; Amr Mostafa; Hesham A. Elmeligy; Amira Kamel; Heba Khalil

doi:10.3889/oamjms.2022.9700

Authors

Safia Samir Department of Biochemistry and Molecular Biology, Theodor Bilharz Research Institute, Giza, Egypt
Hend Okasha Ahmed Department of Biochemistry and Molecular Biology, Theodor Bilharz Research Institute, Giza, Egypt
Tarek M. Diab Department of Parasitology, Theodor Bilharz Research Institute, Giza, Egypt
Amr Mostafa Department of Surgery, Theodor Bilharz Research Institute, Giza, Egypt
Hesham A. Elmeligy Department of Surgery, Theodor Bilharz Research Institute, Giza, Egypt
Amira Kamel Department of Pathology, Theodor Bilharz Research Institute, Giza, Egypt
Heba Khalil Department of Pathology, Theodor Bilharz Research Institute, Giza, Egypt

DOI:

https://doi.org/10.3889/oamjms.2022.9700

Keywords:

Epstein-Barr virus, Gastric adenocarcinoma, qPCR, Immunohistochemistry, p16 protein

Abstract

BACKGROUND AND AIM: Gastric cancer (GC) is one of the top causes of cancer-related deaths worldwide. According to the Cancer Genome Atlas, there are four subtypes of GC, with the Epstein-Barr virus (EBV) subtype accounting for about 10% of cases. EBV infection causes EBV-associated GC (EBVaGC). The previous research suggested that the presence of the EBV viral genome in gastric carcinomas could be used as a surrogate marker for targeted therapy and optimal GC treatment.

AIM: We aimed to explore the rate of EBV involvement in gastric carcinogenesis from molecular perspective view and to evaluate the role of the tumor-suppressor protein p16 as a marker for diagnosis in GC Egyptian patients in relation to EBV infection.

METHODS: One hundred-four surgically resected GC cases were analyzed. Two methods including quantitative real-time polymerase chain reaction (qPCR) for detecting EBV-derived latent membrane protein-1 (LMP-1) and Epstein-Barr nuclear antigen-1 (EBNA-1) genes as well as immunohistochemistry (IHC) detection of LMP-1 protein and p16 protein on paraffinized tissue blocks were applied.

RESULTS: Using IHC, p16 protein was presented in 90/104 (86.5%) of the GC cases, and EBV LMP-1 was detected in 4 cases (3.84%). qPCR detected 14 cases positive for EBV (13.46%). In EBV positive cases detected using qPCR, no expression of p16 was detected.

CONCLUSION: EBVaGC has a low incidence in Egypt; loss of p16 expression was recognized in EBVaGC and could be considered as a promising biomarker of EBVaGC. The combination of the two methods IHC and qPCR in addition to p16 is recommended for improving the accuracy of identification of infected cancer.

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