월요점심집담회. EndoTODAY 이준행

[SMC Monday GI conference 2017-5-15. EBV-associated gastric cancer (임상강사 홍지택)]

EBV-associated gastric cancer

Incidence: about 10% of gastric carcinoma
Mean age: 60
Male predominance
Gross feature: Ulerated suacer(납작한 접시)-like mass, Marked thickening of gastric wall
Predisposition to the non-antrum of the stomach: Proximal stomach, Remnant stomach after subtotal gastrectomy
Characteristic microscopic features: Gastric carcinoma with lymphoid stroma (GCLS), Lymphoepithelioma-like carcinoma, Carcinoma with Crohn's disease-like lymphoid reaction, Lace pattern in the mucosal layer
Behavior: low rate of lymph node metastasis, better prognosis

Cell free virus는 감염능력이 낮으나 한 세포에서 다른 세포로 옮기는 효율은 훨씬 높습니다.
Latent protein 발현 양상에 따라 세 가지 type을 나눌 수 있습니다. 위암은 latency type I과 type II과 관련된 것으로 생각됩니다. 처음에는 latency type III로 시작하다가 latent protein 발현을 down regulation 하여 latency type II와 type I으로 변형됩니다.

Remnant gastric cancer에서의 감염율이 그냥 proximal gastric cancer보다 훨씬 더 많습니다. Billroth II에서 더 높다고 합니다.

한번 감염되면 cure 되는 경우는 없습니까?

언제 면역형광염색을 시행합니까? 어떤 항체를 이용하여 검사를 하는 것입니까?

Saucer-like mass라고 하셨는데...

LECL의 얼마나 감염되어 있나요? 80% 이상이라고 했는데요...

Submucosal invasion이 많은 이유는? (J Surg Res 2014) The patients with LELC are male predominant and had more upper locations, more indeterminate Lauren classifications, lower T stages, less lymphatic invasion, and more positive EBV in situ hybridization compared with those of the NLELC group (80.4% versus 6.5%). Age, histologic type, Lauren type, the location of the tumor, the depth of the invasion, lymph node metastasis, and venous invasion were independent prognostic factors; however, the LELC type itself was not predictive of outcome. The 5-y survival rate of the LELC group (97.7%) was better than that of the NLELC group (89.4%); however, this difference was not statistically significant (P = 0.127). cancer_232.html article_201604.html