Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2018; 24(43): 4928-4938
Published online Nov 21, 2018. doi: 10.3748/wjg.v24.i43.4928
Association between Helicobacter pylori, Epstein-Barr virus, human papillomavirus and gastric adenocarcinomas
Carolina Rosal Teixeira de Souza, Marcelli Carolini Alves Almeida, André Salim Khayat, Emerson Lucena da Silva, Paulo Cardoso Soares, Luiz Cláudio Chaves, Rommel Mario Rodríguez Burbano
Carolina Rosal Teixeira de Souza, Marcelli Carolini Alves Almeida, André Salim Khayat, Emerson Lucena da Silva, Rommel Mario Rodríguez Burbano, Laboratory of Human Cytogenetics, Institute of Biological Sciences, Federal University of Pará, Belém, Pará 66075-110, Brazil
André Salim Khayat, Rommel Mario Rodríguez Burbano, Oncology Research Center, Federal University of Pará, João de Barros Barreto University Hospital, Belém, Pará 66073-000, Brazil
Paulo Cardoso Soares, Luiz Cláudio Chaves, Rommel Mario Rodríguez Burbano, Ophir Loyola Hospital, Belém, Pará 66060-281, Brazil
Author contributions: de Souza CR and Almeida MC contributed to this work equally, carried out the studies, collected the data, performed the statistical analysis and drafted the manuscript; Khayat AS performed the statistical analysis and participated in its design; da Silva EL performed the statistical analysis and drafted the manuscript; Soares PC, Chaves LC and Burbano RM participated in critical revision and editing of the manuscript; Burbano RM conceptualized and designed the study and helped to draft the manuscript; all authors read and approved the final manuscript.
Supported by the National Council for scientific and technological development, No. (CNPq) 402283/2013-9.
Institutional review board statement: This study was approved by the Ethics Committee of the João de Barros Barreto University Hospital in Belém, No. 142004 and No. 637.233.
Informed consent statement: Patients were not required to give informed consent for the publication because the study and analysis used anonymous data that were obtained after each patient agreed to the collection of pieces of the tumors by written consent.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: The authors agree that if this manuscript is finally accepted for publication, the Copyright License Agreement will become effective immediately.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Carolina Rosal Teixeira de Souza, PhD, Adjunct Professor, Laboratório de Citogenética Humana, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa, 1 - Guamá, Belém, Pará 66075-110, Brazil.
Telephone: +55-91-32018188 Fax: +55-91-32018188
Received: June 8, 2018
Peer-review started: June 8, 2018
First decision: July 4, 2018
Revised: September 11, 2018
Accepted: October 5, 2018
Article in press: October 5, 2018
Published online: November 21, 2018
Research background

Gastric cancer (GC) is the world’s fourth leading cause of cancer deaths, and microbial infections have been shown to contribute to gastric tumorigenesis.

Research motivation

Gastric physiology and immunology are known to be altered by Helicobacter pylori (H. pylori) and Epstein-Barr virus (EBV), although there is still doubt about the association of GC with some pathogens, such as human papillomavirus (HPV).

Research objectives

The present study aimed to elucidate the possible relationship of these microorganisms with the clinical-pathological characteristics of patients with GC in the North region of Brazil.

Research methods

A total of 302 gastric adenocarcinomas were collected between 2005 and 2015. Patient samples were categorized according to the TNM classification system and by histology. Molecular techniques were used for pathogen investigations, as they are more sensitive.

Research results

All three pathogens were found in the samples; however, active HPV infection was not identified. Coinfections of H. pylori-cagA+ and EBV were correlated with tumors at the most advanced stages.

Research conclusions

HPV was not involved in gastric tumorigenesis. On the other hand, H. pylori and EBV seem to be directly related to the development and severity of tumors, especially when coinfections exist.

Research perspectives

Prophylactic and therapeutic measures against H. pylori and EBV may prevent the development of GC, especially the more aggressive forms.