Abstract:
Background and objectives: This study aims to elucidate the prognostic implications of Epstein-Barr virus (EBV) infection in gastric carcinomas (GCs) through a systematic review and meta-analysis. Materials and Methods: In total, 57 eligible studies and 22,943 patients were included in this meta-analysis. We compared the prognoses of EBV-infected and non-infected GC patients. The subgroup analysis was performed based on the study location, molecular classification, and Lauren\'s classification. This study was checked according to the PRISMA 2020. The meta-analysis was performed using the Comprehensive Meta-Analysis software package. Results: EBV infection was found in 10.4% (95% confidence interval (CI) 0.082-0.131) of GC patients. The EBV-infected GC patients had a better overall survival compared with the EBV-non-infected GC patients (hazard ratio (HR) 0.890, 95% CI 0.816-0.970). In the subgroup analysis based on molecular classification, no significant differences were found between EBV+ and microsatellite instability and microsatellite stable (MSS)/EBV- subgroups (HR 1.099, 95% CI 0.885-1.364 and HR 0.954, 95% CI 0.872-1.044, respectively). In the diffuse type of Lauren\'s classification, EBV-infected GCs have a better prognosis compared with the EBV-non-infected GCs (HR 0.400, 95% CI 0.300-0.534). The prognostic impact of EBV infection was found in the Asian and American subgroups but not in the European subgroup (HR 0.880, 95% CI 0.782-0.991, HR 0.840, 95% CI 0.750-0.941, and HR 0.915, 95% CI 0.814-1.028). Conclusions: EBV infection is a favorable survival factor for GCs. However, the prognostic implications of EBV infection in the new molecular classification are not clear.
摘要:
背景与目的:本研究旨在通过系统评价和荟萃分析,阐明EB病毒(EBV)感染在胃癌(GCs)中的预后意义。材料和方法:总计,57项符合条件的研究和22,943例患者被纳入该荟萃分析。我们比较了EBV感染和未感染GC患者的预后。根据研究地点进行亚组分析,分子分类,和劳伦的分类。这项研究是根据PRISMA2020进行检查的。采用综合Meta分析软件包进行Meta分析。结果:在GC患者中,有10.4%(95%置信区间(CI)0.082-0.131)发现EBV感染。与未感染EBV的GC患者相比,感染EBV的GC患者具有更好的总体生存率(风险比(HR)0.890,95%CI0.816-0.970)。在基于分子分类的子群分析中,EBV+和微卫星不稳定性和微卫星稳定(MSS)/EBV-亚组之间没有发现显着差异(分别为HR1.099,95%CI0.885-1.364和HR0.954,95%CI0.872-1.044)。在劳伦分类的扩散类型中,与未感染EBV的GCs相比,感染EBV的GCs具有更好的预后(HR0.400,95%CI0.300-0.534)。EBV感染的预后影响在亚洲和美国亚组中发现,但在欧洲亚组中没有发现(HR0.880,95%CI0.782-0.991,HR0.840,95%CI0.750-0.941和HR0.915,95%CI0.814-1.028)。结论:EBV感染是GCs生存的有利因素。然而,EBV感染在新的分子分类中的预后意义尚不清楚.