J Med Assoc Thai 2023; 106 (4):S26-30

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Clinicopathological Features of Epstein-Barr Virus-associated Intrahepatic Cholangiocarcinoma
Sa-Ngiamwibool P Mail, Putraveephong S , Sookprasert A , Titapun A , Wirasorn K , Meesing A , Watcharenwong P , Twinprai P , Chindaprasirt J

Background: Epstein-Barr virus (EBV) was found to be associated with many cancers. Only a few cases of EBV-associated cholangiocarcinoma were reported and most of them were lymphoepithelioma-like tumors. The objective of this study was to determine the prevalence of EBV in intrahepatic cholangiocarcinoma in the Thai population.

Material and methods: A total of 40 cholangiocarcinoma tumors were retrieved by simple random sampling. EBV status was assessed by EBV-encoded small RNA (EBER) in situ hybridization from formalin-fixed paraffin-embedded (FFPE) tumor samples. The association between EBV status and clinicopathological characteristics was analyzed using Fisher's exact test, and survival analysis was done using the Kaplan-Meier method.

Results: Out of 40 intrahepatic cholangiocarcinoma tumor samples, 3 (7.5%) were positive for EBV by EBER in situ hybridization. The median age of EBV-positive patients was lower than the EBV-negative group (52 vs 64 years). All three EBV-positive intrahepatic cholangiocarcinoma cases were presented in stage I (T1N0M0). Two patients were well-differentiated adenocarcinoma and 1 was mucinous cystadenocarcinoma. There was a trend toward better survival was seen in EBV-positive patients (p=0.085).

Conclusion: EBV-associated intrahepatic cholangiocarcinoma is rare, only 7.5%, even in the endemic area.

Keywords: biliary duct cancer, intrahepatic cholangiocarcinoma, Epstein-Barr virus (EBV), EBV-associated cancer, EBER

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