Research Papers:
Clinical utility of circulating cell-free Epstein–Barr virus DNA in patients with gastric cancer
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Abstract
Katsutoshi Shoda1, Daisuke Ichikawa1, Yuji Fujita1,2, Kiyoshi Masuda2, Hidekazu Hiramoto1, Junichi Hamada1, Tomohiro Arita1, Hirotaka Konishi1, Toshiyuki Kosuga1, Shuhei Komatsu1, Atsushi Shiozaki1, Kazuma Okamoto1, Issei Imoto2, Eigo Otsuji1
1Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan
2Department of Human Genetics, Graduate School of Biomedical Sciences, Tokushima University, Tokushima 770-8503, Japan
Correspondence to:
Daisuke Ichikawa, email: [email protected]
Issei Imoto, email: [email protected]
Keywords: gastric cancer, Epstein–Barr virus, liquid biopsy
Received: October 29, 2016 Accepted: February 6, 2017 Published: February 24, 2017
ABSTRACT
Recent comprehensive molecular subtyping of gastric cancer (GC) identified Epstein–Barr virus (EBV)-positive tumors as a subtype with distinct salient molecular and clinical features. In this study, we aimed to determine the potential utility of circulating cell-free EBV DNA as a biomarker for the detection and/or monitoring of therapeutic response in patients with EBV-associated gastric carcinoma (EBVaGC). The EBV genes-to-ribonuclease P RNA component H1 ratios (EBV ratios) in the GC tumors and plasma samples were determined by quantitative real-time polymerase chain reaction in 153 patients with GC, including 14 patients with EBVaGC diagnosed by the conventional method. Circulating cell-free EBV DNA was detected in 14 patients with GC: the sensitivity and specificity of detection were 71.4% (10/14) and 97.1% (135/139), respectively. Plasma EBV ratios were significantly correlated with the size of EBVaGC tumors, and the plasma EBV DNA detected before surgery in EBVaGC cases disappeared after surgery. Patients with EBVaGC may have a better prognosis, but circulating cell-free EBV DNA had no or little impact on prognosis. In addition, repeated assessment of the plasma EBV ratio in EBVaGC showed a decrease and increase in plasma EBV DNA after treatment and during tumor progression/recurrence, respectively. These results suggest the potential utility of circulating cell-free DNA to reveal EBV DNA for the identification of the EBVaGC subtype and/or for real-time monitoring of tumor progression as well as treatment response in patients with EBVaGC.
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