{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:02:25Z","timestamp":1787770945707,"version":"build-2784847793"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,7,16]],"date-time":"2022-07-16T00:00:00Z","timestamp":1657929600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,7,16]],"date-time":"2022-07-16T00:00:00Z","timestamp":1657929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Science Foundation of Peking University Cancer Hospital","award":["2021-12"],"award-info":[{"award-number":["2021-12"]}]},{"name":"the Capital\u2019s Funds for Health Improvement and Research","award":["2018\u20132-1022"],"award-info":[{"award-number":["2018\u20132-1022"]}]},{"name":"the Beijing Municipal Science and Technology Commission NOVA Program","award":["2010 B033"],"award-info":[{"award-number":["2010 B033"]}]},{"name":"the Beijing Municipal Science and Technology Commission Capital Characteristic Clinical Application Research","award":["Z141107002514077"],"award-info":[{"award-number":["Z141107002514077"]}]},{"DOI":"10.13039\/100014718","name":"Innovative Research Group Project of the National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["61501039"],"award-info":[{"award-number":["61501039"]}],"id":[{"id":"10.13039\/100014718","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Peking University Medicine Seed Fund for Interdisciplinary Research","award":["BUM2020MX009"],"award-info":[{"award-number":["BUM2020MX009"]}]},{"name":"PKU-Baidu Fund","award":["No.2020BD036"],"award-info":[{"award-number":["No.2020BD036"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Adenosquamous carcinoma (ASC)with concurrent gastric carcinoma with lymphoid stroma (GCLS) are extremely rare tumors. There are only limited cases reported in the literature. Epstein\u2013Barr virus (EBV) infection was found in the concomitant GCLS, but none in the ASC. Here, we report the first case of gastric cancer with EBV infection detected in both ASC and GCLS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 59-year-old man complained of intermittent upper abdominal pain. The gastric endoscopy revealed a type IIc tumor located in the gastric body near the fundus of the stomach. Histological examination of the gastric tumor showed the coexistence of ASC and GCLS. Both components were positive for EBV-encoded RNA (EBER) in situ hybridization. Neoplastic nests of the former were positive for p63, p40 and CK5\/6. The glandular components showed positive acid mucus in the Alcian-blue periodic-acid-schiff (AB-PAS) staining. There was significant difference in the expression of epidermal growth factor receptor (EGFR) between adenocarcinoma and squamous carcinoma, but not in other proteins such as human epidermal growth factor receptor 2 (HER2), p53 and mismatch repair proteins. The role of EGFR signaling pathway needs to be further explored in the differentiation of squamous carcinoma in the gastric ASC. Finally, a diagnosis of early EBV associated gastric ASC with concurrent GCLS (pT1bN1) was made. The patient took a single-drug S1 periodically for half a year after the surgery and has been disease free during 8 months of medical follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This is the first case of EBV associated gastric ASC with concurrent GCLS, and pathologists and clinicians should recognize and pay attention to this type of tumor.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12876-022-02417-4","type":"journal-article","created":{"date-parts":[[2022,7,16]],"date-time":"2022-07-16T10:15:42Z","timestamp":1657966542000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Epstein\u2013Barr virus-associated gastric adenosquamous carcinoma with concurrent gastric carcinoma with lymphoid stroma: a case report and review of the literature"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2319-3293","authenticated-orcid":false,"given":"Fang","family":"Cao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongfeng","family":"Niu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaozheng","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinting","family":"Diao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3440-9077","authenticated-orcid":false,"given":"Zhongwu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,16]]},"reference":[{"issue":"6","key":"2417_CR1","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1007\/s10120-020-01095-z","volume":"23","author":"E Ignatova","year":"2020","unstructured":"Ignatova E, Seriak D, Fedyanin M, et al. Epstein\u2013Barr virus-associated gastric cancer: disease that requires special approach. Gastric Cancer. 2020;23(6):951\u201360.","journal-title":"Gastric Cancer"},{"key":"2417_CR2","doi-asserted-by":"publisher","first-page":"6628412","DOI":"10.1155\/2020\/6628412","volume":"2020","author":"JS Pyo","year":"2020","unstructured":"Pyo JS, Kim NY, Son BK, et al. Clinicopathological features and prognostic implication of gastric carcinoma with lymphoid stroma. Gastroenterol Res Pract. 2020;2020:6628412.","journal-title":"Gastroenterol Res Pract"},{"issue":"1","key":"2417_CR3","doi-asserted-by":"publisher","first-page":"4597","DOI":"10.1038\/s41598-017-04563-2","volume":"7","author":"F Feng","year":"2017","unstructured":"Feng F, Zheng G, Qi J, et al. Clinicopathological features and prognosis of gastric adenosquamous carcinoma. Sci Rep. 2017;7(1):4597.","journal-title":"Sci Rep."},{"issue":"2","key":"2417_CR4","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1111\/his.13975","volume":"76","author":"ID Nagtegaal","year":"2020","unstructured":"Nagtegaal ID, Odze RD, Klimstra D, et al. The 2019 WHO classification of tumours of the digestive system. Histopathology. 2020;76(2):182\u20138.","journal-title":"Histopathology"},{"issue":"6","key":"2417_CR5","doi-asserted-by":"publisher","first-page":"e527","DOI":"10.3747\/co.27.6337","volume":"27","author":"HS Li","year":"2020","unstructured":"Li HS, Liu X, Zhang MY, et al. Clinicopathologic characteristics, survival, and treatments for gastric adenosquamous carcinoma: a population-based study. Curr Oncol. 2020;27(6):e527\u201336.","journal-title":"Curr Oncol"},{"issue":"3","key":"2417_CR6","doi-asserted-by":"publisher","first-page":"505","DOI":"10.4103\/IJPM.IJPM_174_18","volume":"62","author":"K Ji-Hoon","year":"2019","unstructured":"Ji-Hoon K, Dae-Woon E. A case of multifocal EBV associated gastric carcinoma with focal squamous differentiation. Indian J Pathol Microbiol. 2019;62(3):505\u20137.","journal-title":"Indian J Pathol Microbiol"},{"issue":"1","key":"2417_CR7","first-page":"77","volume":"11","author":"H Miyake","year":"2019","unstructured":"Miyake H, Miyasaka C, Ishida M, et al. Simultaneous gastric adenosquamous carcinoma and gastric carcinoma with lymphoid stroma: a case report. Mol Clin Oncol. 2019;11(1):77\u201380.","journal-title":"Mol Clin Oncol"},{"issue":"63","key":"2417_CR8","first-page":"969","volume":"52","author":"J Takita","year":"2005","unstructured":"Takita J, Kato H, Miyazaki T, et al. Primary squamous cell carcinoma of the stomach: a case report with immunohistochemical and molecular biologic studies. Hepatogastroenterology. 2005;52(63):969\u201374.","journal-title":"Hepatogastroenterology"},{"issue":"4","key":"2417_CR9","doi-asserted-by":"publisher","first-page":"2020","DOI":"10.1097\/CJI.0000000000000316","volume":"43","author":"T Xie","year":"2020","unstructured":"Xie T, Liu Y, Zhang Z, et al. Positive status of Epstein\u2013Barr virus as a biomarker for gastric cancer immunotherapy: a prospective observational study. J Immunotherapy. 2020;43(4):2020.","journal-title":"J Immunotherapy"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-022-02417-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-022-02417-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-022-02417-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,16]],"date-time":"2022-07-16T10:16:54Z","timestamp":1657966614000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-022-02417-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,16]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["2417"],"URL":"https:\/\/doi.org\/10.1186\/s12876-022-02417-4","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,16]]},"assertion":[{"value":"30 October 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 July 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 July 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"346"}}