PTEN and gastric cancer: Similarly, EBV-associated gastric cancer (EBVaGC) displays a unique CpG island hypermethylation phenotype, driven by latent viral proteins such as LMP2A that upregulate DNMT1 and DNMT3B expression, leading to the silencing of tumor suppressor genes including CDKN2A, PTEN, and MLH1 (Naseem et al., 2018) Despite these well-characterized promoter-level changes, our study detected no significant difference in Alu methylation, suggesting that EBV’s epigenetic effects may be selective and not extend to repetitive elements (Matsusaka et al., 2014).