Panel of significant risk factors predicts early stage gastric cancer and indication of poor prognostic association with pathogens and microsatellite stability

Abstract

Background There are very few studies covering the epidemiological risk factors associated with Epstein Barr Virus (EBV) and Microsatellite stability for Gastric Cancer (GC) cases. Early diagnosis of GC through epidemiological risk factors is very necessary for the clinical assessment of GC. The aim of this study was to find out the major risk factors to predict GC in early stage and the impact of pathogen infection and MSI on survival rate of patients. GC samples were screened for Helicobacter pylori, Epstein Barr Virus, and Mismatch repair (MMR) gene status (microsatellite stable or instable). Chi-square and logistic regression analysis of Odd ratio and 95% confidence interval (OR, 95% CI) were performed to find out the association between epidemiological factors and the risk of gastric cancer. The pathogen and MMR gene status were analysed to predict their effect on overall survival and the risk score and hazard ratio was calculated for prognostic assessment. Results Excess body weight, consumption of extra salt, smoked food, alcohol, and smoking were the major risk factors for GC development. This study achieved a high area under the curve (AUC 0.94) for the probable GC patients in early-stage using the five-panel epidemiological risk factors. H. pylori infected cases were significant with smoked food, while EBV was found to be associated with tuibur intake and smoked food. In overall survival analysis EBV infected and microsatellite stable (HR: 1.32 and 1.34 respectively) GC cases were showing poor prognosis. Conclusion This study might provide new opportunities for personalized treatment options using this epidemiological factor risk score and clinicopathological factors assessment for early detection and prognosis in high-risk GC populations.

Low incidence of microsatellite instability in gastric cancers and its association with the clinicopathological characteristics: a comparative study

“…Similarly, in China, a study involving 1757 gastric cancer patients reported a prevalence of 10.5% for MSI-H 32 . In a South Asian study conducted in India, a prevalence of 40% was reported 33 in which BAT-25, BAT-26, and dinucleotide markers of D2S123, D17S250, D16S752, D16S265, D16S398, D16S496, D18S58, and D16S3057 were utilized to identify MSI-H phenotype. Additionally, MSI-H has identified whether at least two markers were unstable or just instability was observed in the BAT-26 Maker.…”

Cancer awareness, diagnosis and treatment needs in Mizoram, India: evidence from 18 years trends (2003–2020)

“… 37 Although precise statistical data regarding daily meat intake eluded us, cultural factors indicate a propensity toward high meat consumption. 33 , 38 , 39 …”

“…Prior investigations conducted within Mizoram have revealed a heightened risk (OR > 1) of Gastric Cancer among tuibur users, with a noteworthy correlation (OR > 1) between Helicobacter pylori infection (a bacterium linked to gastritis and Stomach cancer) and the consumption of tuibur and smoked food, including “sa-um”. 38 , 40 Moreover, cigarette smoking, alcohol consumption and insufficient intake of fruits and vegetables are well-recognized risk factors for distinct subtypes of Gastric Cancer. 41 The prevailing rates of Stomach cancer and H. pylori infection, coupled with their connection to specific lifestyle practices within the Mizo population, imply the presence of distinct population-specific lifestyle and demographic factors that warrant thorough investigation to effectively tackle the disease.…”

Co-infection relationship with Epstein-Barr virus in gastroduodenal diseases with Helicobacter Pylori. Quantitative PCR and EBNA-1 gene-based approach

“…GC is a multifactorial and complex malignant disease, and it is one of the few malignant diseases that are known to play a role in the etiology of infectious agents (such as Hp and EBV) (14,15). The frequency and distribution of GC subtypes and the prevalence of Hp differ according to the geographic region (16).…”