It exhibits distinct molecular features such as phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) mutations, hypermethylation of DNA, and overexpression of programmed cell death ligand 1 (PD-L1) and programmed cell death ligand 2 (PD-L2), suggesting that EBV infection contributes to the malignant transformation of normal cells in gastric carcinogenesis (3, 8). This evidence concerns the gene PIK3CA and Epstein-Barr virus infection.