ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Demographic/Clinicopathological Characteristics and Prognosis of Resectable Epstein-Barr Virus-Associated Gastric Cancer: A Nested Case-Control Study from an Eastern China
Provisionally accepted
Lihu Gu1
Qiufeng Zhang2
Yuying Hu3
Zhiyi Xiang2
Shengqiang Ji4
Weiming Yu5Xingchen Liu1Ping Chen1
Feng Wu1*Qi Zheng1*- 1Ningbo No. 2 Hospital, Ningbo, China
- 2First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
- 3The First Affiliated Hospital of Ningbo University, Ningbo, China
- 4Ningbo Clinical Pathology Diagnosis Center, Ningbo, China
- 5The Affiliated Lihuili Hospital, Ningbo University, Ningbo, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Epstein-Barr virus-associated gastric cancer (EBVaGC) represents a distinct molecular subtype of gastric cancer (GC). This multicenter study aimed to investigate the clinicopathological characteristics and prognosis of resectable EBVaGC patients. Methods: Data were prospectively collected and retrospectively analyzed from 1,400 patients at Ningbo No. 2 Hospital from January 2014 to December 2023 and 55 EBVaGC patients were identified. Additionally, 95 EBVaGC patients from two external cooperative centers were included. A 1:4 propensity score matching (PSM) analysis was performed between EBVaGC patients and EBV-negative gastric cancer (EBVnGC) patients. Median follow-up duration was 34 months. Results: Among the 150 EBVaGC patients, the median age was 64, and 88.7% were male. Undifferentiated tumors were more common. During the follow-up, 121 EBVaGC patients did not experience recurrence. After PSM, there were 137 EBVaGC patients and 548 EBVnGC patients. In EBVaGC patients, elevated Carcinoembryonic Antigen (CEA) levels (HR=8.11, p=0.025) and pathological tumor-node-metastasis (pTNM) stage III (HR=19.57, p=0.008) were independent risk factors for overall survival (OS). For disease-free survival (DFS), elevated CEA levels (HR=6.23, p=0.035) and pTNM stage III (HR=18.51, p=0.007) were independent risk factors. There was no significant difference in OS between the two groups (p=0.204). Compared to EBVnGC patients, EBVaGC patients showed a trend towards better DFS, although this did not reach statistical significance(p=0.061). Conclusion: EBVaGC patients exhibit unique clinicopathological characteristics and may show a trend toward better prognosis compared with EBVnGC patients, although this difference did not reach statistical significance.
Keywords: Epstein–Barr virus, gastric cancer, prognosis, CEA, pTNM
Received: 28 Mar 2025; Accepted: 15 Dec 2025.
Copyright: © 2025 Gu, Zhang, Hu, Xiang, Ji, Yu, Liu, Chen, Wu and Zheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Feng Wu
Qi Zheng
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.