Circulating Antibodies against Epstein-Barr Virus (EBV) and p53 in EBV-Positive and -Negative Gastric Cancer.

BACKGROUND: Epstein-Barr virus (EBV)-positive gastric cancers have clinicopathologic differences from EBV-negative tumors and lack TP53 mutation. Serologic profiles may inform viral contribution to carcinogenesis. METHODS: We compared humoral responses of EBV-positive (n = 67) and EBV-negative (n = 137) patients with gastric cancer from the International EBV-Gastric Cancer Consortium. Serum antibodies against four EBV proteins, nuclear (EBNA), viral capsid (VCA), early-diffuse (EA-D), and Zta replication activator (ZEBRA), and to p53 were assessed by multiplex assays. OR of antibody level tertiles (T1-T3) were adjusted by logistic regression. We also conducted a meta-analysis of reported anti-p53 seropositivity in gastric cancer. RESULTS: Consistent with EBV's ubiquity, 99% of patients were seropositive for anti-EBNA and 98% for anti-VCA, without difference by tumor EBV status. Seropositivity varied between patients with EBV-positive and EBV-negative tumors for anti-EA-D (97% vs. 67%, respectively, P < 0.001) and anti-ZEBRA (97% vs. 85%, respectively, P = 0.009). Adjusted ORs (vs. T1) for patients with EBV-positive versus EBV-negative tumors were significantly elevated for higher antibodies against EBNA (2.6 for T2 and 13 for T3), VCA (1.8 for T2 and 2.4 for T3), EA-D (6.0 for T2 and 44 for T3), and ZEBRA (4.6 for T2 and 12 for T3). Antibodies to p53 were inversely associated with EBV positivity (3% vs. 15%; adjusted OR = 0.16, P = 0.021). Anti-p53 prevalence from the literature was 15%. CONCLUSIONS: These serologic patterns suggest viral reactivation in EBV-positive cancers and identify variation of p53 seropositivity by subtype. IMPACT: Anti-EBV and anti-p53 antibodies are differentially associated with tumor EBV positivity. Serology may identify EBV-positive gastric cancer for targeted therapies.

[Laparoscopic hysterectomy in the surgical treatment of gynecological malignant and premalignant diseases]. / Histerectomía laparoscópica en el tratamiento quirúgico de enfermedades ginecológicas malignas y premalignas.

INTRODUCTION: Laparoscopic hysterectomy (LH) is a safe surgical approach that offers patients a faster recovery. However, its use in malignant or premalignant gynecological lesions is not well established. The objective of the present study was to show the feasibility of LH in a tertiary cancer center. MATERIAL AND METHODS: We conducted a descriptive analysis of patients with histologically proven malignant or premalignant uterine lesions who underwent to LH. Surgical time, bleeding complications, and hospital stay were evaluated. RESULTS: Twenty-five patients were included with a mean age of 45 years. Ten LH (40%) with or without salpingo-oophorectomy for premalignant or preinvasive malignant lesions were done, five surgical staging procedures for endometrial cancer (20%) and seven radical hysterectomies for cervical cancer (28%). In three patients, conversion from laparotomy (12%) was necessary for operative complications (two cases) or technical problems (one case). Mean operative time for the entire group was 207 min, mean bleeding 204 mL and mean hospital stay was 2.5 days. Postoperative complications were present in two patients, hematoma in the vaginal cupola (one case) and temporary bladder dysfunction (one case). CONCLUSIONS: In the present trial we described our initial experience in LH for the treatment of malignant and premalignant gynecologic diseases. Our results suggest that it is a safe and feasible surgical approach. Long-term surveillance studies are necessary for the evaluation of recurrence patterns and overall survival.