Microsatellite instability and Epstein-Barr virus infection in gastric remnant cancers

Clinicopathological analysis, microsatellite analysis, detection of Epstein -Barr virus (EBV), and immunohistochemistry on p53 protein were performed i n 26 cases of gastric remnant cancer (GRC). They were divided into two grou ps; Group A (n = 14) who had undergone a primary gastrectomy for benign gas tric disease, and Group B (n = 12) who had undergone the same operation for gastric cancer. EBV infection was present in 29% of Group A, 8% of Group B and 6% of the conventional gastric carcinoma (CGC) (Group A vs CGC, P = 0. 01). Microsatellite instability (MSI) was found in 7% of Group A, 25% of Gr oup B, and 9% of the CGC (Group B vs CGC; P = 0.08). p53 Overexpression was observed in 46% of the GRC and 33% of the CGC. p53 Overexpression was obse rved in 90% of the intestinal type of GRC, but in only 20% of the diffuse t ype of GRC (P = 0.002). The cancer stage was a significant factor in the un ivariate analysis of survival (P = 0.04). In conclusion, GRC is different f rom CGC in terms of MSI or EBV association. The pathogenetic differences be tween the two groups require further investigation. EBV infection may have been involved in the carcinogenesis of Group A. MSI may be an important fac tor in the carcinogenesis of metachronous multiple gastric cancer (Group B) .