Abstract
BACKGROUND: Epstein-Barr virus-associated gastric cancer (EBVaGC) is one of the four molecular subtypes of gastric cancer, as defined by the classification recently proposed by The Cancer Genome Atlas. We evaluated the correlation between EBV positivity and (18)F-fluorodeoxyglucose ((18)F-FDG) uptake by positron emission tomography/computed tomography (PET/CT) in patients with gastric cancer. MATERIALS AND METHODS: We retrospectively enrolled patients with gastric cancer who underwent pretreatment (18)F-FDG PET/CT and subsequent surgical resection, and then were diagnosed with advanced gastric cancer (pathologic stage ≥T2 with any N stage). Maximum standardized uptake values (SUV(max)) of gastric cancer were measured by pretreatment (18)F-FDG PET/CT. EBV sequences were detected by in situ hybridization (ISH) techniques. We analyzed the correlation between EBV positivity, clinicopathologic features and metabolic activity of the primary tumor. RESULTS: A total of 205 patients were included and 15 (7.3%) patients were identified as having EBV-positive gastric cancer. Age, gender, tumor location, and histological type showed no significant differences between EBV-positive and negative groups. EBV-positive cancer is significantly more frequent in the higher-metabolic-tumor group than in the lower one (p=0.032). The mean SUV(max) of gastric cancers showed significant differences between EBV-positive and negative groups (9.9±4.2 vs. 7.0±4.8, p=0.026). CONCLUSION: The infection status of EBV was significantly related to the (18)F-FDG uptake of primary tumors in patients with advanced gastric cancer.