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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.
