Abstract
The study aimed to investigate the role of serum EBV-VCA IgG in assessing gastric cancer (GC) risk and prognosis. A total of 1790 Northern Chinese participants with pathologically confirmed disease underwent EBV-VCA IgG serologic testing using enzyme-linked immunosorbent assay (ELISA), including 821 controls, 410 atrophic gastritis (AG) patients, and 559 GC patients. We found that positive EBV-VCA IgG was significantly associated with GC and its precursor, conferring a 1.55- and 1.36-fold increased risk of GC and AG, respectively (P = 0.001, 95% CI = 1.21-1.99; P = 0.011, 95% CI = 1.07-1.72, respectively). The risk effects were more remarkable in younger, female, and Helicobacter pylori-negative individuals than in older, male, and H. pylori-positive individuals. EBV-VCA IgG-positive subjects had a lower PGI/II ratio than EBV-VCA IgG-negative subjects (median 8.0 vs 8.8, P = 0.001), especially those in the H. pylori-positive (median 6.1 vs 6.8, P = 0.027) and GC subgroups (median 6.4 vs 7.9, P = 0.020). In the intestinal GC subgroup, the survival of EBV-VCA IgG-positive patients was worse than that of EBV-VCA IgG-negative patients (P = 0.041, HR = 2.45, 95% CI = 1.04-5.78). Our study suggests that EBV-VCA IgG seropositivity has potential in predicting the risk of GC and its precursor as well as the prognosis of histologically classified GC.