AbstractBackgroundsEarly gastric cancer (EGC) with mixed‐type histology is a significant risk factor for additional surgery after endoscopic submucosal dissection (ESD). On the other hand, Epstein–Barr virus‐associated gastric cancer (EBVaGC) with mixed‐type histology is a favorable risk factor with regard to lymph node metastasis.MethodsWe performed EBV detection in 13 ESD‐proven lesions in 13 cases of early gastric cancer with mixed‐type histology using EBV‐encoded small RNA1 in situ hybridization (EBER1 ISH).ResultsEBVaGC was diagnosed in only one (7.7%) of the tested lesions. That EBVaGC patient underwent surgery and there was no residual lesion and no lymph metastasis. EBVaGC is not frequent in EGC with mixed‐type histology.ConclusionsEBV testing of gastric biopsy specimens seems not to be useful to predict the mixed‐type histology results of ESD. However, EBV testing for ESD specimens of EGC with mixed‐type histology is expected to be useful for avoiding excessive additional surgery.