Viral loads correlate with upregulation of PD-L1 and worse patient prognosis in Epstein-Barr Virus-associated gastric carcinoma

PLoS One. 2019 Jan 29;14(1):e0211358. doi: 10.1371/journal.pone.0211358. eCollection 2019.

Abstract

Epstein-Barr virus (EBV)-associated gastric carcinoma (EBVaGC), one of four major gastric cancer types, consists of clonal growth of EBV-infected epithelial cells. However, the significance of viral loads in each tumor cell has not been evaluated. EBV-DNA is stably maintained in episomal form in the nucleus of each cancer cell. To estimate EBV copy number per genome (EBV-CN), qPCR of viral EBNA1 and host GAPDH, standardized by Namalwa DNA (one copy/genome), was applied to the formalin-fixed paraffin embedded (FFPE) surgically resected EBVaGC specimens (n = 43) and EBVaGC cell lines (SNU-719 and NCC-24). In surgical specimens, the cancer cell ratio (CCR) was determined with image analysis, and EBV-CN was obtained by adjusting qPCR value with CCR. Fluorescent in situ hybridization (FISH) was also applied to the FFPE sections using the whole EBV-genome as a probe. In surgical specimens, EBV-CN obtained by qPCR/CCR was between 1.2 and 185 copies with a median of 9.9. EBV-CN of SNU-719 and NCC-24 was 42.0 and 1.1, respectively. A linear correlation was observed with qPCR/CCR data up to 20 copies/genome (40 signals/nucleus), the limit of FISH analysis. In addition, substantial variation in the number of EBV foci was observed. Based on qPCR/CCR, high EBV-CN (>10 copies) correlated with PD-L1 expression in cancer cells (P = 0.015), but not with other pathological indicators. Furthermore, EBVaGC with high EBV-CN showed worse disease-specific survival (P = 0.041). Our findings suggest that cancer cell viral loads may contribute to expression of the immune checkpoint molecule and promotion of cancer progression in EBVaGC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • B7-H1 Antigen / genetics*
  • Cell Line, Tumor
  • Disease Progression
  • Epstein-Barr Virus Infections / genetics*
  • Epstein-Barr Virus Infections / virology
  • Epstein-Barr Virus Nuclear Antigens / genetics*
  • Female
  • Gene Dosage
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / growth & development*
  • Humans
  • In Situ Hybridization, Fluorescence
  • Male
  • Middle Aged
  • Prognosis
  • Stomach Neoplasms / genetics
  • Stomach Neoplasms / virology*
  • Survival Analysis
  • Up-Regulation*
  • Viral Load

Substances

  • B7-H1 Antigen
  • CD274 protein, human
  • Epstein-Barr Virus Nuclear Antigens
  • EBV-encoded nuclear antigen 1

Grants and funding

This work was supported by Grant Number 26253021, Japan Society for the Promotion of Science, URL: https://www.jsps.go.jp/, to MF. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.