Gastric Carcinoma and Epstein-Barr Virus Association (EBVaGC): Pusan Kyungnam Area

PURPOSE: To report on the incidence of EBVaGC and its associated clinical and pathological characteristics. METHODS: Between Nov. 1998 and Mar. 2000, 183 gastric cancers were resected, and the histology and lymphocytes infiltration reviewed. The EBVaGC was determined by EBER ISH, along with the clinical characteristics, such as sex distribution, tumor location, ABO blood group, status of H. pylori and postop survival. RESULTS: Out of 183 gastric adenocarcinomas 10 were EBVaGCs (5.5%), 7/129 males and 3/54 females. The incidences of EBVaGC, according to the WHO histology, were 7.1% (4/56) for tub. po, 9.3% (4/43) tub. mo, 4.1% (2/48) tub. well, 0/11 muc., 0/3 pap. and 0/22 sig. types. The incidences of EGVaGC, in relation to the severity of lymphocytic infiltration of tumor, were 0% (0/141) for Less- than-minimal, 21% (8/38) for Moderate and 50% (2/4) for Severe infiltration of the lymphocytes (P=0.000). The incidences of EGVaGC, according to the location of gastric cancer, were 26.3% (5/19), 7.3% (3/41) and 1.8% (2/110) for the upper, middle and lower stomach, respectively (P= 0.000). The incidences of EBVaGC were 3.1% (3/96) for stages I-II and 8% (7/87) for stages III-IV. The blood type distributions of the EBVaGCs, by the ABO blood group system were 3 A type, 6 B type, no O type and 1 AB type compared with 42.8% (74), 27.1% (47), 19.6% (34) and 10.5% (18) of A, B, O and AB with the 173 non EBVaGC P=0.079). The H. pylori status was positive in 9/10 EBVaGC, and in 157/163 (96.3%) of the non-EBVaGC. The survivals of the EBVaGC and non EBVaGC were 80 and 61.4% (105/171), rspectively. CONCLUSION: The incidence of EBVaGC was 5.5%. There was no difference in the sex ratio with EBV ( )ve gastric cancer. Six out of the 10 EBVaGC were ABO blood group B.

Prognosis of Malignant Obstructive Jaundice Following Surgery for Gastric Carcinoma / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Obstructive jaundice is a rare presentation, but is an ominous prognostic sign in patients undergoing surgery for a gastric carcinoma. Therefore, we investigated the prognosis of malignant obstructive jaundice following surgery for a gastric carcinoma. MATERIALS AND METHODS: Thirty-eight patients, with an extrahepatic biliary obstruction due to a metastatic gastric carcinoma, were retrospectively studied to determine their demographics, clinical features, laboratory finding, pathological characteristics and survival. RESULTS: Between January 1996 and April 2000, 2401 patients underwent operations for gastric cancer, of which 38 (1.6%) were found to have obstructive jaundice. The mean age was 55.9 +/- 10.7 years, and the sex ratio (male: female) was 3.2: 1. The median interval between the previous gastrectomy and the presentation of jaundice was 10.1 8.9 months. The levels of total bilirubin and direct bilirubin were 16.5 +/- 6.5 and 12.0 +/- 4.4, respectively. The most common site of the obstruction was the common bile duct (65%). An antrumal location, poorly differentiated stage IV gastric cancer was common associated with obstructive jaundice. A percutaneous transhepatic biliary drainage was a commonly used treatment modality. When the clinical and laboratory findings were presented to a Cox regression analysis, the P values of the time interval and albumin were 0.019 and 0.057, respectively. CONCLUSION: The time interval between a previous gastrectomy, the presentation of jaundice and albumin level were found to be independent risk factors for predicting the survival.