[Gastric cancer: epidemiologic profile 2001-2007 in Lima, Peru]. / Cancer gastrico: perfil epidemiológico 2001-2007 en Lima, Peru.

OBJECTIVE: To describe and compare the demographic and social characteristics as well as lifestyles of patients with gastric cancer against patients with other important gastric disorders, who attended at main reference health services in Lima, Peru. METHODS: Case control study, matched by sex and age + 2 years, applying a questionnaire to 96 cases with gastric cancer, and to 96 controls from September 2001 to November 2007. RESULTS: There were no significant differences about ethnicity; marital status; exposure to minerals, wood, and metal dusts; tobacco and alcohol; red meat consumption; salt addition; food temperature. 87, 5% of the control group had lesions in the gastric antrum, and 73% of cases group had a tubular adenocarcinoma (56%) in the gastric antrum. There was no family history of cancer in 85% patients of cases group and 59% of controls, (with significant difference). There were significant differences in low scholarship level of cases, as well as for their mothers and fathers (OR 3.75, 3.9, and 3.49 respectively), fruit or vegetables intake, milk or cheese consumption (minus of once a day) (OR 2, 3, 2, 57 and 2, 9 respectively), type of fuel for cooking (firewood, charcoal, and kerosene OR 5, 25), lack of use of refrigerator (OR 8, 4). CONCLUSIONS: The profile of a gastric cancer patient was to proceed from the Andean zone (high altitude +3000 meters over sea level) and jungle, low education level (low socioeconomic level), low consumption of fruits, vegetables and milk, use of firewood, charcoal, or kerosene to cook, and no use of refrigerator. The most frequent histological diagnosis in the case group was tubular adenocarcinoma.

Human papillomavirus-16 is integrated in lung carcinomas: a study in Chile.

The human papillomavirus (HPV) was detected in 20 (29%) out of 69 lung carcinomas (LCs) in Chile, by PCR and Southern blot, and was more frequently detected in squamous cell carcinoma (SQC) than in adenocarcinomas (46 vs 9%, P=0.001). HPV-16, positive in 11 cases, was the most frequently detected HPV genotype determined by DNA sequencing. HPV-16 E2/E6 ratio, estimated from real-time PCR analysis, was much lower than the unity, suggesting that at least a partial HPV-16 genome was integrated in all but one HPV-16-positive SQCs. The remaining one case was suspected to have only episomal HPV-16. Although the viral load was low in most of the LCs, a case showed the HPV-16 copy number as high as 8479 per nanogram DNA, which was even a few times higher than the minimum viral load of seven cervical carcinomas (observed viral load: 3356-609 392 per nanogram DNA). The expression of the HPV-16/18 E6 protein was found in only two HPV-16-positive SQCs (13%) but not in the case with the highest viral load. Although the viral load was in general very low and HPV E6 expression is none or weak, further studies seem warranted to examine aetiological involvement of high-risk HPV in lung carcinogenesis.

Nasal natural killer/T-cell lymphoma and its association with type "i"/XhoI loss strain Epstein-Barr virus in Chile.

BACKGROUND: Nasal T/natural killer (NK)-cell lymphoma is an aggressive type of non-Hodking's lymphoma associated with Epstein-Barr virus (EBV) and striking geographical variations worldwide. AIM: To characterise nasal NK/T-cell lymphoma associated with genotypes of EBV in Chile, a Latin American country, where multiple strains of EBV, including two new recombinant strains, in healthy individuals were recently found. METHODS: Cases with diagnosis of primary nasal lymphoma were selected for histological and immunohistochemical analysis (CD3, CD3e, CD4, CD8, CD79a, CD56, CD57 and TIA-1) and in-situ hybridisation, serology and genotyping analysis for EBV. RESULTS: Out of 22 cases, 9 (41%) cases fulfilled the World Health Organization criteria for nasal NK/T-cell lymphoma; of these 7 (78%) cases were positive for EBV. Genotyping analysis revealed 6 cases of type 1 EBV and wildtype F at the BamHI-F region, 4 cases type "i" EBV at the BamHI-W1/I1 region; XhoI wild type was found in 2 and XhoI loss in 4 cases, respectively. Cosegregation analysis of the BamHI-W1/I1 region and XhoI restriction site showed the new recombinant strain type "i"/XhoI loss in 3 cases and type "i"/XhoI wild-type strain in 1 case. Most patients were treated with combined anthracycline-containing regimens. Half of the cases attained complete remission. CONCLUSION: Although nasal NK/T-cell lymphomas from Chile share similar clinicopathological features, high association with EBV and unfavourable prognosis with those described elsewhere, genotype analysis shows that the new recombinant type "i"/XhoI loss strain might contribute to explain the intermediate incidence of nasal NK/T-cell lymphomas in Latin America.

Epstein-Barr virus-associated gastric carcinoma in Lima, Peru.

We examined 254 gastric carcinomas (GCs) diagnosed in four hospitals in Lima, Peru, and its suburban area during the period between 1994-2001. Epstein-Barr virus (EBV)-associated gastric carcinoma (EBVaGC) was identified by the in situ hybridization (ISH) technique to detect EBV-encoded small RNA (EBER) in gastric tissue. EBVaGCs, where EBER ISH staining was observed in all carcinoma cells, accounted for 3.9% (10/254) of gastric adenocarcinomas, the lowest frequency ever reported in Latin American countries. EBVaGC incidence rates in Peru, which we estimated on the basis of the present study and cancer incidence in Lima, were 0.8 per 100,000 among men and 0.5 per 100,000 among women. These estimates are much lower than those reported in our previous studies in Colombia (4.1 and 1.4 per 100,000 among men and women, respectively), a neighboring country, and in Japan (6.4 and 1.1 per 100,000 among men among women, respectively). Interestingly, EBVaGC in Peru showed no evident male predominance, as opposed to the findings reported in a majority of studies. Other clinicopathological features of EBVaGC in Peru were similar to those found in literature: EBVaGC showed no age dependence, a predominance in the non-antrum part of the stomach, and high frequencies in histological subtypes of moderately differentiated tubular adenocarcinoma and solid poorly differentiated adenocarcinoma. There was a case of well-differentiated adenocarcinoma showing a partial EBER-1-positive staining. In this carcinoma, the tumor in the body (middle third of the stomach) was EBER-1 positive but the tumor in the stomach antrum showed no noticeable EBER-1 ISH staining. We suspect this was a case of synchronous double carcinomas. Further studies are needed to identify the cause of the low frequency and lack of male predominance of EBVaGC in Peru.

Epstein-Barr virus in gastric carcinoma is associated with location in the cardia and with a diffuse histology: a study in one area of Chile.

Epstein-Barr virus (EBV) has been associated with the most common form of stomach neoplasms, the gastric carcinoma (GC). The presence of EBV-encoded small RNAtype-1 (EBER-1), a marker for EBV infection was analyzed by in situ hybridization (ISH) in 185 formalin-fixed and paraffin-embedded cases of GC from a high risk region. We found 31 (16.8%) EBV-positive cases with no relationship to age. Although male predominance (19% in males and 12.5% in females) was observed, the gender difference did not achieve statistical significance. Odds ratio (OR) for cardia location was 5.4 (95% CI 1.7-17.3) when antrum was used as referent category and the effects of gender and age were taken into account. The proportion of EBV-positive cases in diffuse histology was higher than intestinal type (OR = 4.8, 95% CI = 2.0-11.1). Our findings are contrary to a previously accepted hypothesis, that high-risk countries for GC have low rates of EBV-associated GC. In addition, our findings regarding location, histology and weak male predominance are different from what has been described in Asian and European countries, but similar to those described in Mexico and Mexican descendants living in the U.S. suggesting unique characteristics of EBV-associated GC in Latin-America.

Epstein-Barr virus-associated gastric carcinoma in Japanese Brazilians and non-Japanese Brazilians in São Paulo.

The proportion of Epstein-Barr virus-associated gastric carcinoma (EBV-GC) was examined in 149 Japanese-Brazilian and 151 non-Japanese-Brazilian gastric-carcinoma cases using in situ hybridization (ISH) assay to detect EBV-encoded small RNA (EBER), and the results were compared with our referent Japanese data. We found that 4.7% of cases in Japanese Brazilians were EBER-positive. This frequency was slightly lower than that of the referent Japanese, among whom 6.2% of 2038 gastric-carcinoma cases were EBER-positive. On the other hand, the non-Japanese-Brazilian series showed a significantly higher proportion of EBV-GC (11.2%) than the referent group did (P = 0.01). Although EBV-GC was predominant in males among non-Japanese Brazilians (M / F = 3.6, P = 0.047), as was the case in Japanese (M / F = 2.7), Japanese Brazilians did not show such a male predominance. The sex-ratio difference between the Japanese Brazilians and Japanese was statistically significant (P = 0.005). In conclusion, the present study in Japanese Brazilians and Japanese yielded no evidence suggesting any change in the frequency of EBV-GC caused by migration, except the absence of male predominance, which was observed both in Japanese and non-Japanese Brazilians.

Epstein-Barr virus-associated gastric carcinoma in Mexico: analysis of 135 consecutive gastrectomies in two hospitals.

Epstein-Barr virus (EBV) has been implicated in the genesis of gastric carcinoma. The presence of clonal episomal viral forms in the nuclei of neoplastic gastric epithelial cells suggests that viral infection occurs before the development of gastric carcinoma. Mexico is a country at high risk for gastric cancer-it is the second cause of death among patients who die of cancer in that country. A series of 135 consecutive non-selected gastrectomies from two hospitals in Mexico City were analyzed to search for EBV in gastric carcinomas. EBV-encoded small non-polyadenylated RNA (EBER) in situ hybridization was performed on 5-microm paraffin-embedded tissue sections. Age, gender, anatomical site, histological type, and invasiveness of gastric carcinomas were obtained from the records in the corresponding Departments of Pathology. Eleven (8.15%) of the 135 cases were EBER-1-positive gastric carcinomas. Six occurred in males and five in females. In three women, the neoplasia was localized in the antrum. Five of the 11 cases were lymphoepithelioma-like carcinomas and, in two of them, an unusual foreign body-type inflammation was observed. Environmental factors could influence the distinctive pathologic features of EBV-associated gastric carcinoma in the Mexican population.