Clinicopathological and Immunomicroenvironment Characteristics of Epstein-Barr Virus-Associated Gastric Cancer in a Chinese Population

• Published in: Frontiers in oncology 2021-01, Vol.10, p.586752
• Main Authors: Jia, Xiaoxia, Guo, Ting, Li, Zhemin, Zhang, Meng, Feng, Yi, Dong, Bin, Li, Zhongwu, Hu, Ying, Li, Ziyu, Xing, Xiaofang, Jia, Shuqin, Ji, Jiafu
• Format: Article
• Language: English
• Subjects: CD3; CD68; Epstein–Barr virus (EBV); gastric cancer; immune microenvironment; Oncology
• ISSN: 2234-943X; 2234-943X
• DOI: 10.3389/fonc.2020.586752

Epstein-Barr virus-associated gastric cancer(EBVaGC)has a unique tumor immune microenvironment. We performed a comprehensive analysis of the tumor-infiltrating immune cells in a cohort of EBVaGC in a Chinese population. Epstein-Barr encoding region (EBER) hybridization was performed in 1,328 consecutive cases of surgically resected GC. Densities of immune cells, including T cells, B cells, natural killer cells, and macrophages from the patients were calculated after immunohistochemical staining with CD3, CD20, CD57, and CD68 antibodies in tissue microarrays, respectively. EBVaGC patients accounted for 4.1% (55 of 1,328) cases in the overall population. The average age of patients with EBVaGC was lower than that of non-EBVaGC patients. Histologically, EBVaGC patients exhibited poorly differentiated adenocarcinoma (P = 0.004) and lower frequency of vascular invasion (P = 0.034). The density of CD3 T lymphocytes (CD3, 23.84 ± 14.49 12.76 ± 8.93, P < 0.001) and CD68 macrophages (CD68, 9.73 ± 5.25 5.44 ± 4.18, P < 0.001) was significantly higher in EBVaGC patients. CD3 T cell density predicted better 5-year overall survival of EBVaGC patients (P = 0.022). EBVaGC patients were younger with low-differentiated adenocarcinoma and less vascular invasion. Increased infiltration of multiple immune cells affected the prognosis of patients, especially EBVaGC patients with more CD3 T lymphocytes, who survived longer.