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Yogi N, Usui G, Matsusaka K, Fukuyo M, Fujiki R, Seki M, Takano S, Abe H, Morikawa T, Ushiku T, Ohtsuka M, Kaneda A. Association of tumors having Epstein-Barr virus in surrounding lymphocytes with poor prognosis. Cancer Med 2022; 12:1122-1136. [PMID: 35726701 PMCID: PMC9883551 DOI: 10.1002/cam4.4967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/12/2022] [Accepted: 06/10/2022] [Indexed: 02/02/2023] Open
Abstract
Infection with certain viruses is an important cause of cancer. The Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium recently analyzed the whole-genome sequencing (WGS) data from 2656 cases across 21 cancer types, and indicated that Epstein-Barr virus (EBV) is detected in many different cancer cases at a higher frequency than previously reported. However, whether EBV-positive cancer cases detected by WGS-based screening correspond to those detected by conventional histopathological techniques is still unclear. In this study, to elucidate the involvement of EBV in various cancers, we reanalyzed the WGS data of the PCAWG cohort combined with the analysis of clinical samples of gastric and pancreatic cancer in our cohort. Based on EBV copy number in each case, we classified tumors into three subgroups: EBV-High, EBV-Low, and EBV-Negative. The EBV-High subgroup was found to be EBV-positive in the cancer cells themselves, whereas the EBV-Low subgroup was EBV-positive in the surrounding lymphocytes. Further, the EBV-Low subgroup showed a significantly worse prognosis for both gastric cancer and across cancer types. In summary, we classified tumors based on EBV copy number and found a unique cancer subgroup, EBV-positive in the surrounding lymphocytes, which was associated with a poor prognosis.
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Affiliation(s)
- Norikazu Yogi
- Department of General Surgery, Graduate School of MedicineChiba UniversityJapan,Department of Molecular Oncology, Graduate School of MedicineChiba UniversityJapan
| | - Genki Usui
- Department of Molecular Oncology, Graduate School of MedicineChiba UniversityJapan,Department of Pathology, Graduate School of MedicineThe University of TokyoTokyoJapan,Department of Diagnostic PathologyNTT Medical Center TokyoTokyoJapan
| | - Keisuke Matsusaka
- Department of Molecular Oncology, Graduate School of MedicineChiba UniversityJapan,Department of PathologyChiba University HospitalChibaJapan
| | - Masaki Fukuyo
- Department of Molecular Oncology, Graduate School of MedicineChiba UniversityJapan
| | - Ryoji Fujiki
- Department of Molecular Oncology, Graduate School of MedicineChiba UniversityJapan,Cancer Genomics CenterChiba University HospitalChibaJapan
| | - Motoaki Seki
- Department of Molecular Oncology, Graduate School of MedicineChiba UniversityJapan,Cancer Genomics CenterChiba University HospitalChibaJapan
| | - Shigetsugu Takano
- Department of General Surgery, Graduate School of MedicineChiba UniversityJapan
| | - Hiroyuki Abe
- Department of Pathology, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Teppei Morikawa
- Department of Diagnostic PathologyNTT Medical Center TokyoTokyoJapan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Masayuki Ohtsuka
- Department of General Surgery, Graduate School of MedicineChiba UniversityJapan
| | - Atsushi Kaneda
- Department of Molecular Oncology, Graduate School of MedicineChiba UniversityJapan
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Yin W, Jin J, Bao H, Chen H, Wang C, Cheng G, Wu C, Wu M, Yan J, Wu X, Shao Y, Ni X, Su D. Tumor infiltrating lymphocytes-based subtypes and genomic characteristics of EBV- associated lymphoepithelioma-like carcinoma. J Pathol 2022; 257:650-662. [PMID: 35451500 DOI: 10.1002/path.5916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/19/2022] [Accepted: 04/19/2022] [Indexed: 11/08/2022]
Abstract
Tumor infiltrating lymphocytes (TILs) offer a key for morphological diagnosis of lymphoepithelioma-like carcinoma (LELC) and are the foundation of onco-immunology. To date, no reports have found a specific risk stratification value of TILs and related it to genomic variation in LELC. Based on the stromal TILs (str-TILs) ratio, we classified 105 EBV-associated LELC cases into two subtypes: patients with ≥ 60% str-TILs area ratio in tumor were classified as subtype I, and otherwise as subtype II. Subtype I patients had significantly better progression-free survival (PFS) and overall survival (OS). We also explored genomic characteristics of EBV-associated LELC within different involved organs. We performed whole-exome sequencing for 51 patients with enough tissue and analyzed genomic characteristics of EBV-associated LELC. Overall, EBV-associated LELCs were characterized by low somatic mutation rate and copy number variations; the enriched genetic lesions affected RTK-RAS, PI3K and cell cycle pathways. Moreover, EBV-associated LELCs from different organs were more similar to each other genetically as compared with other traditional carcinomas of the same sites -as evidenced by unsupervised clustering based on the quantitative data from both mutation signature and chromosomal aneuploidies. Notably, EBV-associated LELC patients with oncogenic driver alterations showed a worse prognosis compared with patients without such alterations. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- WenJuan Yin
- Department of Pathology, The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital, Hangzhou, Zhejiang, PR China.,Institute of Basic Medicine and Cancer (IBMC)s, Chinese Academy of Sciences, Hangzhou, Zhejiang, PR China
| | - JiaoYue Jin
- Department of Pathology, The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital, Hangzhou, Zhejiang, PR China.,Institute of Basic Medicine and Cancer (IBMC)s, Chinese Academy of Sciences, Hangzhou, Zhejiang, PR China
| | - Hua Bao
- Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu, PR China
| | - HanLin Chen
- Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu, PR China
| | - CanMing Wang
- Department of Pathology, The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital, Hangzhou, Zhejiang, PR China.,Institute of Basic Medicine and Cancer (IBMC)s, Chinese Academy of Sciences, Hangzhou, Zhejiang, PR China
| | - GuoPing Cheng
- Department of Pathology, The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital, Hangzhou, Zhejiang, PR China.,Institute of Basic Medicine and Cancer (IBMC)s, Chinese Academy of Sciences, Hangzhou, Zhejiang, PR China
| | - ChaoQi Wu
- Department of Pathology, The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital, Hangzhou, Zhejiang, PR China.,Institute of Basic Medicine and Cancer (IBMC)s, Chinese Academy of Sciences, Hangzhou, Zhejiang, PR China
| | - Meijuan Wu
- Department of Pathology, The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital, Hangzhou, Zhejiang, PR China.,Institute of Basic Medicine and Cancer (IBMC)s, Chinese Academy of Sciences, Hangzhou, Zhejiang, PR China
| | - Junrong Yan
- Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu, PR China
| | - Xue Wu
- Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu, PR China
| | - Yang Shao
- Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu, PR China.,School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Xinghao Ni
- Department of Pathology, The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital, Hangzhou, Zhejiang, PR China.,Institute of Basic Medicine and Cancer (IBMC)s, Chinese Academy of Sciences, Hangzhou, Zhejiang, PR China
| | - Dan Su
- Department of Pathology, The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital, Hangzhou, Zhejiang, PR China.,Institute of Basic Medicine and Cancer (IBMC)s, Chinese Academy of Sciences, Hangzhou, Zhejiang, PR China
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3
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Verocq C, Racu ML, Bafort D, Butorano G, Perez-Casanova Garcia L, Navez J, Witterwulghe M, Sheahan K, Swan N, Closset J, Van Laethem JL, Maris C, D'Haene N. Pancreatic medullary carcinoma developed on a pancreatic intraductal papillary mucinous neoplasm with loss of MSH2 and MSH6 expression: a case report. Diagn Pathol 2021; 16:117. [PMID: 34895278 PMCID: PMC8667442 DOI: 10.1186/s13000-021-01178-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/02/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Pancreatic medullary carcinoma (PMC) is a rare pancreatic tumor, usually showing the presence of microsatellite instability, mostly MLH1 silencing, and a wild-type KRAS mutation status. We report here a PMC arising from a Pancreatic Intraductal Papillary Mucinous Neoplasm (IPMN), both having KRAS and TP53 mutations. CASE PRESENTATION We report the case of a 73-year-old woman presenting with right iliac fossa pain. MRI revealed a 16 mm diameter mass in the pancreas, leading to a pancreatic duct stricture and upstream a dilatation of the distal pancreatic duct of Wirsung. A fine needle aspiration was performed, and pathology analysis revealed malignant glandular cells. The patient underwent distal pancreatectomy. Gross examination revealed an12 mm indurated white lesion, adjacent to a cystic lesion extending into the rest of the pancreatic body. Microscopically, the cystic area represented a mixed (gastric-type and pancreatobiliary-type) IPMN, involving the main and secondary pancreatic ducts with low-grade and high-grade dysplasia. In the periphery of this IPMN, a 14mm associated invasive carcinoma was observed, characterized by focal gland formation and by poorly differentiated cells with a syncytial appearance, associated with a dense lymphoplasmocytic and neutrophilic infiltrate. Immunohistochemical analyses showed loss of MSH2 and MSH6 expression. Microsatellite instability was confirmed by molecular test. Molecular analysis was performed both on the invasive carcinoma and on the high-grade dysplasia IPMN, revealing the same mutation profile with KRAS and TP53 mutations. The proposed diagnosis was mixed IPMN with associated invasive medullary carcinoma that presented loss of MSH2 and MSH6 expression. CONCLUSIONS The present case reports for the first time, at the best of our knowledge, the coexistence of IPMN lesions and PMC, both having the same molecular alterations. It also describes the second case of PMC with microsatellite instability, MSH2 and MSH6 silenced.
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Affiliation(s)
- Camille Verocq
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.
- Hôpital Erasme, Route de Lennik, 808 Laboratoire d'anatomopathologie, hôpital de jour, 2ième étage, 1070, Bruxelles, Belgium.
| | - Marie-Lucie Racu
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Dominique Bafort
- Centre Universitaire Inter Régional d'Expertise en Anatomie Pathologique Hospitalière (CurePath), 6040, Charleroi, Belgium
| | - Gloria Butorano
- Centre Universitaire Inter Régional d'Expertise en Anatomie Pathologique Hospitalière (CurePath), 6040, Charleroi, Belgium
| | | | - Julie Navez
- Department of Hepato-Biliary-Pancreatic Surgery, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Marc Witterwulghe
- Department of Gastroenterology, CHIREC Hospitals, Delta, Brussels, Belgium
| | - Kieran Sheahan
- Department of Pathology, UCD School of Medicine, St Vincent's University Hospital, Dublin, Ireland
| | - Niall Swan
- Department of Pathology, UCD School of Medicine, St Vincent's University Hospital, Dublin, Ireland
| | - Jean Closset
- Department of Hepato-Biliary-Pancreatic Surgery, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Jean-Luc Van Laethem
- Department of Gastroenterology and Digestive oncology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Calliope Maris
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Centre Universitaire Inter Régional d'Expertise en Anatomie Pathologique Hospitalière (CurePath), 6040, Charleroi, Belgium
| | - Nicky D'Haene
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Chen B, Chen X, Zhou P, Yang L, Ren J, Yang X, Li W. Primary pulmonary lymphoepithelioma-like carcinoma: a rare type of lung cancer with a favorable outcome in comparison to squamous carcinoma. Respir Res 2019; 20:262. [PMID: 31752892 PMCID: PMC6873444 DOI: 10.1186/s12931-019-1236-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 11/07/2019] [Indexed: 02/05/2023] Open
Abstract
Background Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare tumor and often misdiagnosed as squamous carcinoma. In the current study, clinical characteristics and outcome of primary pulmonary LELC were systematically compared with pulmonary squamous carcinoma. Methods Forty-two cases of primary pulmonary LELC and 134 squamous carcinomas were enrolled retrospectively. Characteristic and prognosis difference between the two groups was compared, and the independent prognostic factor for pulmonary LELC was identified as well. Results In comparison to squamous carcinoma, pulmonary LELC was more common in women with a younger median age and less smokers. LELC seemed to be smaller in diameter on computed tomography (CT) scans than squamous carcinoma, with scarce spiculation and vascular convergence signs. Epstein-Bar virus-encoded RNA (EBER) by in-situ hybridization was detected in 33 LELC cases, among whom 27 ones were positive in serum EBV-DNA examination. LELC patients presented a much longer median progression-free survival (PFS) than squamous carcinoma. Positive serum EBV-DNA, distant lymph node invasion, advanced clinical stage and receiving radiotherapy were correlated with the shorter PFS in LELC patients. However, only positive serum EBV-DNA was the independent PFS predictor. Conclusion Pulmonary LELC looks like distinct from squamous carcinoma. Middle-aged women and nonsmokers are comparatively predominated. CT features of pulmonary LELC are relatively less-malignant. Correspondently, the progression of pulmonary LELC is seemingly favorable than squamous carcinoma and the positive serum EBV-DNA appears to be the predictor of PFS.
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Affiliation(s)
- Bojiang Chen
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China
| | - Xuping Chen
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China
| | - Ping Zhou
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China
| | - Lan Yang
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China
| | - Jing Ren
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China
| | - Xiaodong Yang
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China.
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, No. 37, Guo Xue Alley, Chengdu, 610041, Sichuan, China.
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5
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Pinto A, Huang M, Nadji M. Lymphoepithelioma-Like Carcinoma of the Uterine Cervix: A Pathologic Study of Eight Cases With Emphasis on the Association With Human Papillomavirus. Am J Clin Pathol 2019; 151:231-239. [PMID: 30321260 DOI: 10.1093/ajcp/aqy130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Objectives Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix is a rare tumor. The goal of this study was to evaluate a series of cases of cervical LELC and to investigate possible association with human papillomavirus (HPV) and/or Epstein-Barr virus (EBV). Methods Immunohistochemistry for p63, p16, human leukocyte antigen-D related (HLA-DR), and B-cell lymphoma 2 (BCL-2); in situ hybridization (ISH) for EBV and HPV; and polymerase chain reaction (PCR) genotyping were performed. Mismatch repair (MMR) studies and PD-L1 status were obtained. Results We found eight cases of LELC. Tumors demonstrated sheets of cells containing vesicular nuclei, amphiphilic cytoplasm, and dense peri- and intratumoral lymphocytic infiltrates. All tumors stained for p63, p16, and HLA-DR; two also stained for BCL-2. When combining ISH and PCR results, seven tumors were HPV positive; they were all Epstein-Barr encoding region negative. All cases were MMR intact, and most overexpressed PD-L1. Conclusions This study shows that cervical LELCs are associated with HPV and not EBV.
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Affiliation(s)
- Andre Pinto
- Department of Pathology, University of Miami Miller School of Medicine, Miami, FL
| | - Marilyn Huang
- Department of Obstetrics and Gynecology, Division of Gynecology Oncology, University of Miami Miller School of Medicine, Miami, FL
| | - Mehrdad Nadji
- Department of Pathology, University of Miami Miller School of Medicine, Miami, FL
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Bedri S, Sultan AA, Alkhalaf M, Al Moustafa AE, Vranic S. Epstein-Barr virus (EBV) status in colorectal cancer: a mini review. Hum Vaccin Immunother 2018; 15:603-610. [PMID: 30380978 DOI: 10.1080/21645515.2018.1543525] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Epstein-Barr virus (EBV) is a well-characterized oncovirus, associated with several malignancies. The complex and heterogeneous nature of colorectal cancer (CRC) has led to many epidemiological causal associations with CRC. However, a direct causal link between microbial infections and CRC has not been established yet. Our review indicates that the current evidence for the presence and role in EBV in CRC is insufficient and contradictory. The design of the analyzed studies, sample size as well as methodology used for EBV detection varied markedly and consequently may not lead to meaningful conclusions. The presence of EBV in other colorectal tumors (lymphomas, smooth muscle tumors) is in line with their status at other anatomic locations and may have therapeutic implications with EBV-specific vaccines. On the other hand, studies exploring EBV in colorectal adenoma-carcinoma sequence and its molecular genetic characteristics are largely missing and may significantly contribute to a better understanding of the role of EBV in CRC.
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Affiliation(s)
| | - Ali A Sultan
- b Weill Cornell Medicine - Qatar , Cornell University, Qatar Foundation - Education City , Doha , Qatar
| | | | - Ala-Eddin Al Moustafa
- d College of Medicine , Qatar University , Doha , Qatar.,e Syrian Research Cancer Centre of the Syrian Society against Cancer , Aleppo , Syria.,f Oncology Department , McGill University , Quebec , Montreal , Canada
| | - Semir Vranic
- d College of Medicine , Qatar University , Doha , Qatar
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7
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Widodo, Pristiwanto B, Rifa'i M, Mustafa I, Huyop FZ. A single epitope of Epstein-Barr Virus stimulate IgG production in mice. Ann Med Surg (Lond) 2018; 35:55-58. [PMID: 30294429 PMCID: PMC6170204 DOI: 10.1016/j.amsu.2018.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 02/01/2023] Open
Abstract
Background Epstein-Barr virus (EBV) is closely associated with the high incidence of nasopharyngeal carcinoma in worldwide. Vaccination is one strategy with the potential to prevent the occurrence of EBV-associated cancers, but a suitable vaccine is yet to be licensed. Much vaccine development research focuses on the GP350/220 protein of EBV as it contains an immunogenic epitope at residues 147–165, which efficiently stimulates IgG production in vitro. We examined the ability of this epitope (EBVepitope) to induce IgG production in mice. Methods The antibody binding pattern of the epitope was analyzed using bioinformatics tools. The IgG production in mice were examined by FACS Calibur™ Flow cytometer. Results The epitope bound the 72A1 monoclonal antibody at the same site as GP350/220 protein, indicating that the epitope should stimulate B cells to produce antibody. Moreover, in vivo administration of EBVepitope successfully induced IgG expression from B cells, compared with controls. Further investigation indicated that the relative number of B cells expressing IgE in EBVepitope-treated mice was lower than controls. Conclusions Our data suggest that this EBV GP350 epitope is able to induce IgG expression in vivo without causing allergic reactions, and represents a potential EBV vaccine candidate. Single EBV epitope adequate stimulate production of IgG in Mice. EBVepitope has similarity structure and binding pattern on Antibody compare with GP350/220 protein. EBVepitope does not stimulate IgE production in Mice. EBVepitope is warrant for further investigation to develop safe EBV vaccine.
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Affiliation(s)
- Widodo
- Biology Department, Faculty of Mathematics and Natural Sciences, Brawijaya University, Malang, Indonesia
| | - Bambang Pristiwanto
- Biology Department, Faculty of Mathematics and Natural Sciences, Brawijaya University, Malang, Indonesia
| | - Muhaimin Rifa'i
- Biology Department, Faculty of Mathematics and Natural Sciences, Brawijaya University, Malang, Indonesia
| | - Irfan Mustafa
- Biology Department, Faculty of Mathematics and Natural Sciences, Brawijaya University, Malang, Indonesia
| | - Fahrul Zaman Huyop
- Biosciences Department, Faculty of Science, Universiti Teknologi Malaysia, 81310 UTM Johor Bahru, Malaysia
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8
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Vranic S, Cyprian FS, Akhtar S, Al Moustafa AE. The Role of Epstein-Barr Virus in Cervical Cancer: A Brief Update. Front Oncol 2018; 8:113. [PMID: 29719817 PMCID: PMC5913353 DOI: 10.3389/fonc.2018.00113] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 03/29/2018] [Indexed: 12/19/2022] Open
Abstract
Epstein–Barr virus (EBV) belongs to the group of gamma-herpes viruses and was the first recognized human oncovirus. EBV is responsible for infectious mononucleosis and multiple lymphoid and epithelial malignancies including B-cell lymphomas (Burkitt lymphoma, Hodgkin lymphoma, and post-transplant lymphoproliferative disorder), various T-cell/NK lymphoproliferative disorders, nasopharyngeal carcinoma, and gastric carcinoma, respectively. In addition, the presence of EBV has been documented in other cancers including breast, prostate, oral, and salivary gland carcinomas. The presence and role of EBV in cervical cancer and its precursor lesions (CIN) have also been described, but the results from the literature are inconsistent, and the causal role of EBV in cervical cancer pathogenesis has not been established yet. In the present review, we briefly surveyed and critically appraised the current literature on EBV in cervical cancer and its variants (lymphoepithelioma-like carcinoma) as well as its precursor lesions (CIN). In addition, we discussed the possible interactions between EBV and human papilloma virus as well as between EBV and immune checkpoint regulators (PD-L1). Though further studies are needed, the available data suggest a possible causal relationship between EBV and cervical cancer pathogenesis.
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Affiliation(s)
- Semir Vranic
- College of Medicine, Qatar University, Doha, Qatar
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9
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Yang AW, Pooli A, Lele SM, Kim IW, Davies JD, LaGrange CA. Lymphoepithelioma-like, a variant of urothelial carcinoma of the urinary bladder: a case report and systematic review for optimal treatment modality for disease-free survival. BMC Urol 2017; 17:34. [PMID: 28449665 PMCID: PMC5408364 DOI: 10.1186/s12894-017-0224-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 04/20/2017] [Indexed: 12/31/2022] Open
Abstract
Background Lymphoepithelioma-like carcinoma (LELC) is a rare high-grade carcinoma that resembles nasopharyngeal lymphoepithelioma and can occur throughout the body. First reported in 1991, bladder LELC has an incidence of about 1% of all bladder carcinomas. Due to its rare occurrence, prognoses and ideal treatment guidelines have not been clearly defined. Methods A PubMed search was performed using two terms, “lymphoepithelioma-like carcinoma” and “bladder.” Review articles, articles in foreign languages, expression studies, and studies not performed in the bladder were excluded. We report a case of LELC of the bladder including treatment and outcome and performed a systematic review of all 36 available English literatures from 1991 to 2016 including the present case to identify factors affecting disease-free survival. Results One hundred forty cases of bladder LELC were analyzed. The mean age of the patients was 70.1 years ranging from 43 to 90 years with 72% males and 28% females. Pure LELC occurs most often at 46% followed by mixed LELC 28% and predominant LELC 26%. EBV testing was negative in all cases tested. Mean follow-up length for all cases was 33.8 months with no evidence of disease in 62.2%, while 11.1% died of disease, 10.4% alive with metastasis, and 8.2% died without disease. 5.0% of cases had recurrence at an average of 31.3 months. Prognosis is significantly favorable for patients presenting with pure or predominant forms of LELC compared to mixed type (p < 0.0001). The treatment significantly associated with the highest disease mortality and lowest disease-free survival was TURBT alone when compared to any multi-modality treatment (p < 0.01). Conclusion We conclude that the best treatment modality associated with the highest disease-free survival is multi-modal treatment including radical cystectomy.
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Affiliation(s)
- Andy W Yang
- Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Aydin Pooli
- Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, NE, USA
| | - Subodh M Lele
- Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, NE, USA
| | - Ina W Kim
- Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, NE, USA
| | - Judson D Davies
- Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, NE, USA
| | - Chad A LaGrange
- Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, NE, USA
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10
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Sun K, Xu S, Wei J, Wang B, Owusu-Ansah KG, Wang W, Wu J, Zheng S. Clinicopathological features of 11 Epstein-Barr virus-associated intrahepatic cholangiocarcinoma at a single center in China. Medicine (Baltimore) 2016; 95:e5069. [PMID: 27749575 PMCID: PMC5059078 DOI: 10.1097/md.0000000000005069] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
To date, only 20 cases of Epstein-Barr virus (EBV)-associated intrahepatic cholangiocarcinomas (IHCCs) have been reported in the literature.Pathology records of IHCC from January 1, 2007 to December 31, 2013 were retrieved from our hospital. Clinical information related to EBV-associated IHCC were also obtained, including gender, age at initial diagnosis, tumor size, tumor-node-metastasis stage, and follow-up duration. Surgically resected stage-matched EBV-negative IHCCs with full follow-up were selected for comparison. All liver specimens were fixed in 10% neutral-buffered formalin and paraffin-embedded tissue blocks containing cholangiocarcinoma and nonneoplastic liver tissue. Hematoxylin and eosin-stained sections were present in all cases.Among 329 primary IHCC patients, intranuclear expression of EBV was only found in 11 patients (3.3%), with an age range of 30 to 67 years (mean, 53.2 years; median, 54 years). The group consisted of 4 male and 7 female patients (M:F ratio 1:1.8). Histopathological analysis showed 1 case (9.1%) belonged to the typical lymphoepithelioma-like carcinoma (LELC), primarily composed of undifferentiated tumor cells intimately admixed with abundant lymphoplasmacytic cells. Two cases (18.2%) belonged to the conventional-type IHCCs, showing irregularly shaped neoplastic glands and scattered lymphoplasmacytic infiltration. The remaining 8 cases (72.7%) belonged to the lymphoepithelioma-like cholangiocarcinomas (LELCCs), showing varied glandular differentiation and dense lymphoplasmacytic infiltration. The overall survival of EBV-positive IHCCs was not significantly different from that of EBV-negative IHCCs (P = 0.512).Our data demonstrate that EBV-associated IHCC is very rare and may be subclassified into 3 different pathological types including LELC, conventional-type IHCC and LELCC on the basis of the tumor cellular differentiation, and host cellular immune responses in the tumors. The etiological, clinical, pathological, and molecular features are needed to be future studied by multicentric efforts in recruiting more EBV-associated IHCC patients.
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Affiliation(s)
| | - Shaoyan Xu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery
- Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health
- Key Laboratory of Organ Transplantation
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Province, Hangzhou, China
| | - Jianfeng Wei
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery
- Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health
- Key Laboratory of Organ Transplantation
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Province, Hangzhou, China
| | | | - Kwabena Gyabaah Owusu-Ansah
- Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health
- Key Laboratory of Organ Transplantation
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Province, Hangzhou, China
| | - Weilin Wang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery
- Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health
- Key Laboratory of Organ Transplantation
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Province, Hangzhou, China
| | - Jian Wu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery
- Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health
- Key Laboratory of Organ Transplantation
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Province, Hangzhou, China
| | - Shusen Zheng
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery
- Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health
- Key Laboratory of Organ Transplantation
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Province, Hangzhou, China
- Correspondence: Shusen Zheng, Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Province, Hangzhou 310003, China (e-mail: )
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