Epstein–Barr virus (EBV) is associated with 5–10% of gastric cancers and is recognized as a distinct molecular subtype. EBV positivity is particularly high in gastric remnant cancer (GRC), which may inform the mode of clinical presentation and findings at endoscopy. Most data are from the East, and the question remains how this applies to a Western cohort. We conducted a population-based study in Central Norway, 2001–2016. Patients with GRC (n = 78) and patients with non-GRC proximally located cancer and available tissue for EBV status (n = 116, control group) were identified from the Norwegian Cancer Registry. Relevant data were collected from the individual patient journals. EBV status was assessed using in situ hybridization. The median latency time from the distal gastrectomy to GRC was 37.6 (range 15.7–68.0) years. GRC more often presented with GI bleeding, 31.0% vs. 16.1%,p= 0.017, and at endoscopy more seldom with an ulcer, 19.7% vs. 38.2%,p= 0.012, or a tumour, 40.8% vs. 66.4%,p< 0.001. For GRC, 18.7% were EBV-positive compared to 6.0% among the controls,p= 0.006. EBV status was not associated with patient age, sex, or Lauren histological type. No difference in long-term survival rates between GRC and controls was found or between EBV-positive vs. -negative GRCs. In conclusion, a higher proportion of GRC cases, compared to controls, are EBV positive, indicating different causative factors. The mode of clinical presentation and findings at endoscopy were more subtle in the patients with GRC.
爱泼斯坦-巴尔病毒（EBV）与5-10%的胃癌相关，并被确认为一种独特的分子亚型。在残胃癌（GRC）中EBV阳性率尤其高，这可能提示其临床表现模式及内镜检查结果的特征。现有数据多来自东方人群，其在西方人群中的适用性仍存疑问。本研究于2001-2016年在挪威中部开展基于人群的研究。通过挪威癌症登记系统，共纳入GRC患者（n=78）及具有可用组织检测EBV状态的近端非GRC胃癌患者（n=116，对照组）。从患者个人病历中收集相关临床资料，采用原位杂交技术检测EBV状态。从远端胃切除术到发生GRC的中位潜伏期为37.6年（范围15.7-68.0年）。与对照组相比，GRC更常表现为消化道出血（31.0% vs. 16.1%，p=0.017），内镜下较少呈现溃疡形态（19.7% vs. 38.2%，p=0.012）或肿瘤样改变（40.8% vs. 66.4%，p<0.001）。GRC组EBV阳性率为18.7%，显著高于对照组的6.0%（p=0.006）。EBV状态与患者年龄、性别或Lauren组织学分型无显著相关性。GRC与对照组之间、以及EBV阳性与阴性GRC之间的长期生存率均无统计学差异。结论表明，与对照组相比，GRC病例中EBV阳性比例更高，提示其致病因素存在差异。GRC患者的临床表现模式及内镜检查结果更为隐匿。
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