• Maryam Abolhasani, Ata Ollah Mohseni, Ramin Shakeri, Ali Khavanin, Mehrdad Khajehei, Abbasali Omidi, Bita Geramizadeh, Ensieh Shafigh, Farshad Naghshvar, Payam Fathizadeh, Leyla Taghizadehgan, Atoosa Gharib, Margaret L Gulley, Sanford M Dawsey, Reza Malekzadeh, Charles S Rabkin, and Mohammad Vasei.
• Oncopathology Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
• Arch Iran Med. 2024 Apr 1; 27 (4): 191199191-199.

BackgroundGastric cancer is the fourth leading cause of cancer-related deaths in the world. The identification of gastric cancer subtypes related to recognizable microbial agents may play a pivotal role in the targeted prevention and treatment of this cancer. The current study is conducted to define the frequency of Epstein-Barr virus (EBV) infection in gastric cancers of four major provinces, with different incidence rates of gastric cancers, in Iran.MethodsParaffin blocks of 682 cases of various types of gastric cancer from Tehran, South and North areas of Iran were collected. Twelve tissue microarray (TMA) blocks were constructed from these blocks. Localization of EBV in tumors was assessed by in situ hybridization (ISH) for EBV-encoded RNA (EBER). Chi-squared test was used to evaluate the statistical significance between EBV-associated gastric cancer (EBVaGC) and clinicopathologic tumor characteristics.ResultsFourteen out of 682 cases (2.1%) of gastric adenocarcinoma were EBER-positive. EBER was positive in 8 out of 22 (36.4%) of medullary carcinomas and 6 out of 660 (0.9%) of non-medullary type, which was a statistically significant difference (P<0.001). The EBVaGCs were more frequent in younger age (P=0.009) and also showed a trend toward the lower stage of the tumor (P=0.075).ConclusionEBV-associated gastric adenocarcinoma has a low prevalence in Iran. This finding can be due to epidemiologic differences in risk factors and exposures, and the low number of gastric medullary carcinomas in the population. It may also be related to gastric tumor heterogeneity not detected with the TMA technique.© 2024 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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