Int J Med Sci 2022; 19(5):924-931. doi:10.7150/ijms.71820 This issue

Research Paper

Epstein-Barr Virus is Associated with Gastric Cancer Precursor: Atrophic Gastritis

Kai Zhao, Yu Zhang, Suhong Xia, Lina Feng, Wangdong Zhou, Mingyu Zhang, Ruonan Dong, Dean Tian, Mei Liu, Jiazhi Liao

Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong university of Science and Technology, Wuhan 430030 Hubei Province, China

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Zhao K, Zhang Y, Xia S, Feng L, Zhou W, Zhang M, Dong R, Tian D, Liu M, Liao J. Epstein-Barr Virus is Associated with Gastric Cancer Precursor: Atrophic Gastritis. Int J Med Sci 2022; 19(5):924-931. doi:10.7150/ijms.71820. Available from

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Graphic abstract

Background: About 10% of gastric cancer (GC) has been described to be Epstein-Barr virus (EBV) positive. Previous researches have described the association between EBV and GC. However, the association of EBV with atrophic gastritis (AG) is underrecognized. Our study aimed to investigate the relationship between EBV and AG and assess the influence of EBV on gastric function.

Methods: A total of 468 pathologically-confirmed chronic gastritis patients underwent circulating EBV DNA test, include 271 non-atrophic gastritis (NAG) and 197 AG patients.

Results: In this study, H. pylori infection rate was 33.3%, EBV infection rate was 40%, and co-infection rate was 15%. The EBV DNA-positive was significantly associated with AG (P=0.031, OR= 1.509, 95% CI 1.037-2.194), especially in H. pylori-negative subjects (P=0.044, OR=1.619, 95% CI 1.012-2.589). EBV DNA-positive patients had a lower pepsinogen I (PG I) / pepsinogen II (PG II) ratio (PGR) than EBV DNA-negative patients (P=0.0026), especially in the AG subgroup (P=0.0062). There was no significant association between EBV and H. pylori co-infection with increased risk of AG (P>0.05).

Conclusion: EBV infection significantly increased the risk of AG, especially in H. pylori-negative patients. The circulating EBV DNA had a potential in predicting the risk of atrophic gastritis.

Keywords: Helicobacter pylori, Epstein-Barr virus, atrophic gastritis, gastric function