Does Epstein-Barr virus cause gastric cancer?
Epstein-Barr virus (EBV) is the causative agent of infectious mononucleosis, and it may also be found in a wide variety of benign and malignant lesions including oral hairy leukoplakia, inflammatory pseudotumor, Hodgkin’s disease, non-Hodgkin’s lymphoma, and nasopharyngeal carcinoma. EBV is strongly associated with about 10% of gastric adenocarcinoma in high prevalence areas of the world (Japan, Hong Kong, China, Korea)(10). These EBV-associated tumors have an unusual histology: prominent lymphoid cell infiltration. They are called lymphoepithelioma-like carcinomas (LELCs) or gastric carcinoma with lymphoid stroma (GCLS) and have histologic features similar to a well known EBV-associated tumor, nasopharyngeal carcinoma. Both well-differentiated and poorly differentiated tumors have been described. The clinical features and natural history are not strikingly different from EBV negative tumors (11). One recent study did report that gastric LELCs tend to have a relatively higher frequency
