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Epstein-Barr virus associated gastric carcinoma: a report from Iran in the last four decades

Afshin Abdirad1*, Siavash Ghaderi-Sohi1, Karem Shuyama2, Chihaya Koriyama2, Hosain Nadimi-Barforoosh1, Sara Emami1, Alireza Mosavi-Jarrahi1, Azin Nahvijou1 and Suminori Akiba2

Author Affiliations

1 The Cancer Research Center, the Cancer Institute, Tehran University of Medical Sciences, Imam Khomeini Medical Center, Keshavarz Blvd., Tehran, Iran

2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Japan

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Diagnostic Pathology 2007, 2:25  doi:10.1186/1746-1596-2-25

Published: 15 July 2007

Abstract

Background

Epstein-Barr virus has been proved to be associated with many of the human malignancy including gastric carcinoma, one of the most important human malignancies in the world. There has been no study about the presence of EBV in gastric adenocarcinoma in Iran.

Methods

We examined the presence of EBV in 273 formalin fixed paraffin-embedded cases of gastric carcinoma from Cancer institute of Tehran University, from 1969 to 2004. In situ hybridization of EBV-encoded small RNA-1 (EBER-1) was conducted. The strain of positive cases was examined by means of polymerase chain reaction and/or restriction fragment length polymorphism analysis.

Results

We found 9 (3%; 95% CI = 1–5%) EBV positive cases. The gender difference was not statisticaly significant. The proportion of EBV-GC cases in diffuse type was higher than intestinal type (OR = 0.08; 95% CI = 0.002–0.64). EBV-GC cases had no relation with age, location and invasion. Six out of 9 EBV-GC cases were born during the period between 1928 and 1930. All 9 cases were Type A. Prototype F was seen in 6 out of 8 cases. Type "i" was found in 8 cases and type I in 1 case. XhoI+ and XhoI- polymorphism accounted 6 and 3 of the cases, respectively.

Conclusion

Our study is the first to describe the frequency of EBV-GC in Iran and the Middle East, highlighting a very low prevalence with specific clinicopathologic features. The predominance of EBV-GC birth year in a fixed period, suggests that EBV infection or other events at early childhood may be related to the development of EBV-GC later in the life. The predominance of the type "i" and XhoI+ cases are contradictory to other studies in Asia and is similar to what is reported from Latin American countries.