SynthesisCancer medicine2026
Prognostic Significance of MSI and EBV Positivity in PD-L1 Positive Gastric Cancer: A Systematic Review and Meta-Analysis.
Synthesis in Cancer medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Spatial specificity of Epstein-Barr virus infection in gastric cancer: A 44-case clinicopathological analysis.Experimental and therapeutic medicine · 2026Article
- Molecular classification and precision therapy in gastric cancer: Current advances and future perspectives (Review).Oncology reports · 2026Review
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Authors and funding
12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsMicrosatellite instability (MSI), programmed death-ligand 1 (PD-L1) expression, and Epstein-Barr virus (EBV) positivity are emerging biomarkers in gastric cancer prognosis and treatment selection, particularly in immunotherapy. This review evaluates their prognostic significance through a systematic review and meta-analysis.
methodsRelevant studies from PubMed, EMBASE, and the Cochrane Library (January 2010 to December 2024) were analyzed. Studies included assessing MSI, PD-L1, and EBV status in gastric cancer using immunohistochemistry, PCR, or in situ hybridization, and reported outcomes such as overall survival (OS), disease-free survival (DFS), or progression-free survival. Data extraction adhered to PRISMA guidelines, and pooled analyses were conducted using a random-effects model (DerSimonian-Laird method). Heterogeneity was assessed using I
resultsA total of 25 studies involving 6494 patients were reviewed. In localized gastric cancer, MSI-high status was associated with significantly improved DFS (hazard ratio [HR], 0.42; 95% confidence interval [CI], 0.23-0.75; p = 0.004) but showed no significant impact on OS (HR, 0.78; 95% CI, 0.48-1.28; p = 0.33) compared to microsatellite stable/PD-L1-negative tumors. EBV-positive/PD-L1-positive cancers demonstrated a prognosis similar to EBV-negative/PD-L1-negative cases (OS: HR, 1.08; 95% CI, 0.81-1.45; p = 0.59).
conclusionsIn metastatic disease, MSI and EBV status were not associated with significant prognostic effects. MSI and EBV status have minimal prognostic value in gastric cancer, particularly for OS, but are essential for selecting candidates for immune checkpoint inhibitors. Standardizing biomarker evaluation is critical to enhancing their clinical relevance.
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