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Article: Epstein-Barr virus-related gastric adenocarcinoma: An early secondary cancer post hemopoietic stem cell transplantation

TitleEpstein-Barr virus-related gastric adenocarcinoma: An early secondary cancer post hemopoietic stem cell transplantation
Authors
Issue Date2005
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro
Citation
Gastroenterology, 2005, v. 129 n. 6, p. 2058-2063 How to Cite?
AbstractBackground & Aims: Epstein-Barr virus (EBV) infection has been associated with some cases of gastric cancer. Methods: We studied a case of early onset gastric adenocarcinoma after nonmyeloablative hematopoietic stem cell transplantation for myeloma in a 56-year-old man. Results: The development of gastric adenocarcinoma was preceded by severe graft-versus-host disease (GVHD) necessitating strong immunosuppression, which resulted in an intense reactivation of EBV infection. Three sequential gastric biopsy examinations performed at 100, 130, and 150 days after hematopoietic stem cell transplantation showed gastritis, dysplasia, and adenocarcinoma, respectively. There was no evidence of Helicobacter pylori infection. Quantitative polymerase chain reaction for circulating EBV showed a surge of EBV DNA peaking at the time of gastritis, followed by a gradual decrease afterward with adequate control of GVHD and tailing of immunosuppression. In situ hybridization for EBV-encoded early small RNA showed absence of EBV in the gastritis specimen, but the presence of EBV in the dysplastic and carcinoma specimens. Aberrant promoter methylation of E-cadherin was observed only in the carcinoma specimens, showing that infection with EBV preceded E-cadherin methylation. Conclusions: Mucosal damage caused by GVHD, immunosuppression, and EBV reactivation combined to lead to EBV infection of the gastric cells and initiation of carcinogenesis, suggesting this case to be a genuine EBV-related opportunistic malignancy post-transplantation. An interesting proposition is that this case also might reflect a compacted timeline of events in EBV-related gastric cancers developing in immunocompetent patients. © 2005 by the American Gastroenterological Association.
Persistent Identifierhttp://hdl.handle.net/10722/76429
ISSN
2015 Impact Factor: 18.187
2015 SCImago Journal Rankings: 7.170
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorAu, WYen_HK
dc.contributor.authorPang, Aen_HK
dc.contributor.authorChan, ECen_HK
dc.contributor.authorChu, KMen_HK
dc.contributor.authorShek, TWHen_HK
dc.contributor.authorKwong, YLen_HK
dc.date.accessioned2010-09-06T07:21:09Z-
dc.date.available2010-09-06T07:21:09Z-
dc.date.issued2005en_HK
dc.identifier.citationGastroenterology, 2005, v. 129 n. 6, p. 2058-2063en_HK
dc.identifier.issn0016-5085en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76429-
dc.description.abstractBackground & Aims: Epstein-Barr virus (EBV) infection has been associated with some cases of gastric cancer. Methods: We studied a case of early onset gastric adenocarcinoma after nonmyeloablative hematopoietic stem cell transplantation for myeloma in a 56-year-old man. Results: The development of gastric adenocarcinoma was preceded by severe graft-versus-host disease (GVHD) necessitating strong immunosuppression, which resulted in an intense reactivation of EBV infection. Three sequential gastric biopsy examinations performed at 100, 130, and 150 days after hematopoietic stem cell transplantation showed gastritis, dysplasia, and adenocarcinoma, respectively. There was no evidence of Helicobacter pylori infection. Quantitative polymerase chain reaction for circulating EBV showed a surge of EBV DNA peaking at the time of gastritis, followed by a gradual decrease afterward with adequate control of GVHD and tailing of immunosuppression. In situ hybridization for EBV-encoded early small RNA showed absence of EBV in the gastritis specimen, but the presence of EBV in the dysplastic and carcinoma specimens. Aberrant promoter methylation of E-cadherin was observed only in the carcinoma specimens, showing that infection with EBV preceded E-cadherin methylation. Conclusions: Mucosal damage caused by GVHD, immunosuppression, and EBV reactivation combined to lead to EBV infection of the gastric cells and initiation of carcinogenesis, suggesting this case to be a genuine EBV-related opportunistic malignancy post-transplantation. An interesting proposition is that this case also might reflect a compacted timeline of events in EBV-related gastric cancers developing in immunocompetent patients. © 2005 by the American Gastroenterological Association.en_HK
dc.languageengen_HK
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastroen_HK
dc.relation.ispartofGastroenterologyen_HK
dc.subject.meshAdenocarcinoma - etiology - pathologyen_HK
dc.subject.meshBiopsyen_HK
dc.subject.meshCadherins - metabolismen_HK
dc.subject.meshEpstein-Barr Virus Infections - etiology - pathologyen_HK
dc.subject.meshGraft vs Host Disease - complications - pathologyen_HK
dc.subject.meshHematopoietic Stem Cell Transplantation - adverse effectsen_HK
dc.subject.meshHerpesvirus 4, Human - genetics - metabolismen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMultiple Myeloma - therapyen_HK
dc.subject.meshNeoplasms, Second Primaryen_HK
dc.subject.meshStomach Neoplasms - etiology - pathologyen_HK
dc.titleEpstein-Barr virus-related gastric adenocarcinoma: An early secondary cancer post hemopoietic stem cell transplantationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0016-5085&volume=129&issue=6&spage=2058&epage=63&date=2005&atitle=Epstein-barr+virus-related+gastric+adenocarcinoma:+an+early+secondary+cancer+post+hemopoietic+stem+cell+transplantationen_HK
dc.identifier.emailChu, KM: chukm@hkucc.hku.hken_HK
dc.identifier.emailKwong, YL: ylkwong@hku.hken_HK
dc.identifier.authorityChu, KM=rp00435en_HK
dc.identifier.authorityKwong, YL=rp00358en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1053/j.gastro.2005.10.011en_HK
dc.identifier.pmid16344071en_HK
dc.identifier.scopuseid_2-s2.0-28844467913en_HK
dc.identifier.hkuros119581en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-28844467913&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume129en_HK
dc.identifier.issue6en_HK
dc.identifier.spage2058en_HK
dc.identifier.epage2063en_HK
dc.identifier.isiWOS:000234079300024-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridAu, WY=7202383089en_HK
dc.identifier.scopusauthoridPang, A=7007044165en_HK
dc.identifier.scopusauthoridChan, EC=7401994120en_HK
dc.identifier.scopusauthoridChu, KM=7402453538en_HK
dc.identifier.scopusauthoridShek, TWH=7005479861en_HK
dc.identifier.scopusauthoridKwong, YL=7102818954en_HK

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