烟台地区EBV相关胃癌临床病理特征及病毒基因分型  

CLINICOPATHOLOGIC CHARACTERISTICS AND GENOTYPING OF EPSTEIN-BARR-VIRUS-ASSOCIATED GASTRIC CARCINOMA IN YANTAI

作　　者：于传亭[1,2] 荆永正 邱清芳[4] 罗兵[1] 王云[1] 

机构地区：[1]青岛大学医学院微生物学教研室,山东青岛266021 [2]烟台市烟台山医院检验科 [3]蓬莱市第二人民医院 [4]莱州市人民医院检验科

出　　处：《青岛大学医学院学报》2013年第5期377-380,385,共5页Acta Academiae Medicinae Qingdao Universitatis

基　　金：山东省自然科学基金资助项目(Y2008C90)

摘　　要：目的明确烟台地区EB病毒(EBV)相关胃癌(EBVaGC)的临床病理特征和病毒基因分型,探讨病毒基因变异与EBVaGC发生的相关性。方法收集烟台地区653例胃癌组织标本和116例健康人群咽漱液(TW)标本,分别采用原位杂交和PCR技术检测筛选EBV阳性标本;PCR结合限制性片段长度多态性及测序检测EBV阳性标本中1/2分型、C/D分型和F/f分型。结果共筛选和鉴定EBVaGC标本40例(6.1%)和EBV阳性TW标本42例(36.2%)。与EBV阴性胃癌比较,EBVaGC在男性中的检出率高于女性(χ2=4.998,P<0.05),在胃底贲门、胃体的检出率高于胃窦(χ2=22.766,q=4.290、5.724,P<0.05),低分化腺癌的检出率高于高分化腺癌、中分化腺癌和黏液腺癌(χ2=17.013,q=3.219～5.041,P<0.05)。40例EBVaGC中1/2型、C/D型和F/f型EBV的比例分别为90.0%/10.0%、42.5%/57.5%和97.5%/2.5%,42例TW标本中3种基因分型的比例分别为81.0%/19.0%、69.0%/31.0%和92.9%/7.1%。EBVaGC和健康人群之间1/2型、F/f型的分布差异均无统计学意义,而EBVaGC中D型EBV的检出率高于健康人群,差异有显著性(χ2=5.863,P<0.05);3种基因型综合分析,1DF型在EBVaGC的检出率高于健康人群(P=0.009)。结论烟台地区EBVaGC占胃癌的6.1%,好发于男性,主要发生在胃底贲门区和胃体(中上2/3),以低分化腺癌多见;EBVaGC中以1型、F型和D型EBV为主,D型变异可能与EBVaGC相关。Objective To identify the clinicopathologic characteristics and virogene typing of Epstein-Barr virus （EBV）- associated gastric carcinoma （EBVaGC） in Yantai, and explore the association of viral genovariation with EBVaGC. Methods Cancer tissue samples in 653 gastric cancer （GC） patients and pharyngeal aspirate （PA） in 116 individuals were collected in Ynatai area. Ey using in-situ hybridization and PCR, EBV-positive samples were detected and screened, and EBV genotypes of types 1/2, F/f and C/D in EBV-positive samples were detected by PCR and restriction fragment length polymorphism or sequencing. Re- sults A total of 40 （6.1%） EBVaGC-positive samples were screened and identified in the 653 patients, and 42 （36.2%） EBV posi- tive samples in 116 PA samples. Compared with EBV-negative GC, the detection rate of EBVaGC was higher in men than in women （X^2=4.998,P〈0.05）, that in gastric fundus and cardia, and in body was higher than in pyloric antrum （X^2=22.766;q=4.290,5.724;P 〈0.05）, that with poorly differentiated adenocarcinoma was higher than that with well-and moderately differentia- ted adenocarcinoma and mucinous adenoearcinoma （X^2= 17.013, q = 3.219 - 5.041, P〈0.05）. In 40 EBVaGCs, EBV type 1/2, type C/D and type F/f accounted for 90.0%/10.0%,42.5%/57.5% and 97.5%/2.5%, respectively, and in 42 PA samples, the ra- tio of the three genotypes were 81.0%/19.0%, 69.0%/31.0% and 92.9%/7.1%, respectively. The differences of distribution of type 1/2 and type F/f between EBVaGC and healthy controls were not significantly different, but in EBVaGC, the detection rate of EBV in type D was higher than that in healthy controls （2~2 = 5.863,P（0.05）. Conclusion EBVaGC accounts for 6.1% of GA in Yantai, more in men, mostly located in gastric fundus, cardia, and in body with poorly differentiated adenocarcinoma. In EBVaGC, types 1, D and F are commonly seen, and the variation of type D may be associated with EBVaGC.

关 键 词：疱疹病毒4型 人 胃肿瘤 病理学 临床 基因型 

分 类 号：R735.2[医药卫生—肿瘤]