Evidence map›Paper›PMID 39873739›Full record

ReviewVirchows Archiv : an international journal of pathology2026

Epstein-Barr virus status drives morphological and molecular intra-tumour heterogeneity in gastric cancer: insights from a case report and literature review.

Irene Gullo, Maria Luísa Sacramento, Rui Morais, Yongsoo Kim, Paul P Eijk, Ana Mafalda Rocha, Diana Baptista, João Santos-Antunes, Bauke Ylstra, Fátima Carneiro

Abstract readCase ReportsReview
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In one paragraph

Review in Virchows Archiv : an international journal of pathology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Irene GulloDepartment of Pathology, Unidade Local de Saúde São João, Porto, Portugal. irene.gullo12@gmail.com.ORCID http://orcid.org/0000-0003-3377-0530
Maria Luísa SacramentoDepartment of Pathology, Unidade Local de Saúde São João, Porto, Portugal.ORCID http://orcid.org/0009-0004-9576-6734
Rui MoraisFaculty of Medicine of the University of Porto (FMUP), Porto, Portugal.ORCID http://orcid.org/0000-0003-1293-3353
Yongsoo KimDepartment of Pathology, Cancer Center Amsterdam, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-2995-2131
Paul P EijkDepartment of Pathology, Cancer Center Amsterdam, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Ana Mafalda RochaInstituto de Investigação E Inovação Em Saúde (i3S) & Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal.
Diana BaptistaDepartment of Pathology, Unidade Local de Saúde São João, Porto, Portugal.ORCID http://orcid.org/0000-0001-8662-169X
João Santos-AntunesFaculty of Medicine of the University of Porto (FMUP), Porto, Portugal.ORCID http://orcid.org/0000-0003-0614-0576
Bauke YlstraInstituto de Investigação E Inovação Em Saúde (i3S) & Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal.ORCID http://orcid.org/0000-0001-9479-3010
Fátima CarneiroDepartment of Pathology, Unidade Local de Saúde São João, Porto, Portugal.ORCID http://orcid.org/0000-0002-1964-1006

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This case report describes a rare case of bi-phenotypic gastric cancer with two distinct, but clonally related, histological components. The first component, associated with Epstein-Barr virus (EBV) infection, exhibited the morphological features of gastric carcinoma with lymphoid stroma, suggesting that EBV, as an effective immunogenic factor, may trigger a prominent immune response within the tumour microenvironment. The second component, which was EBV-negative, displayed tubular/papillary morphology and features of increased biological aggressiveness, such as high-grade areas and lymphatic invasion. Immunohistochemical and molecular studies confirmed that, despite the differing morphologies and immunophenotypes, both components were clonally related, with the EBV-negative area showing more complex DNA aberrations, reminiscent of chromosomally instable (CIN) lesions. This case describes clonally related EBV-positive and -negative components within a single gastric cancer, contributing to a better understanding of EBV role in tumour heterogeneity and progression and highlights the impact of EBV loss on tumour behaviour.

Indexed as

AdenocarcinomaEpstein-Barr Virus InfectionsHerpesvirus 4, HumanStomach NeoplasmsAgedBiomarkers, TumorFemaleHumansImmunohistochemistryMaleMiddle AgedBiomarkers, TumorCopy number analysisEpstein-Barr virus infectionGastric cancer with lymphoid stromaIntra-tumour heterogeneity

Identifiers

PMID39873739

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.