Profiles of Epstein-Barr Virus Associated Gastric Carcinomas in Brunei Darussalam


Background: Gastric cancer is the second most common gastrointestinal cancer and is largely attributedto Helicobacter pylori (H. pylori) infection. In addition, studies have also shown association with Epstein-Barrvirus (EBV) in 10% of gastric cancers. This study assessed the characteristics of EBV associated gastric cancers(EBVaGC) in Brunei Darussalam. Materials and
Methods: This study included gastric cancers diagnosed between2008 and 2012, registered with the Department of Pathology RIPAS Hospital, Brunei Darussalam. Clinical casenotes were systematically reviewed. Histology specimens were all stained for EBV and also assessed for intestinalmetaplasia and H. pylori.
Results: There were a total of 81 patients (54 male and 27 females) with a mean age of65.8±14.8 years included in the study. Intestinal metaplasia and active H. pylori infection were detected in 40.7%and 30.9% respectively. A majority of the tumors were proximally located (55.6%), most poorly differentiated(well differentiated 16%, moderately differentiated 30.9% and poorly differentiated 53.1%) and the stages atdiagnosis were; stage I (44.4%), stage II (23.5%), stage III (8.6%) and stage IV (23.5%). EBV positivity (EBVaGC)was seen in 30.9%. Between EBVaGC and EBV negative gastric cancers, there were no significant differences(age, gender, ethnic group, presence of Intestinal metaplasia, tumor locations, stages of disease and degree oftumor differentiation).
Conclusions: This study showed that a third of gastric cancers in Brunei Darussalamwere positive for EBV, higher than what have been reported in the literature. However, there were no significantdifferences between EBVaGC and EBV negative gastric cancers. This suggests that the role of EBV in gastriccancer may be mostly incidental rather than any causal relation. However, further studies are required.