[Clinicopathological features and prognostic value of CD30 expression in EBV-positive diffuse large B cell lymphoma]

Objective: To explore the clinical and pathological features of EBV-positive diffuse large B cell lymphoma (EBV⁺DLBCL) and to analyze the prognostic significance of CD30 expression in this entity. Methods: A retrospective analysis was conducted from 34 cases of EBV⁺DLBCL and 198 cases of EBV^-DLBCL diagnosed and treated at the First Affiliated Hospital of Nanjing Medical University, from January 2017 to June 2023. Based on CD30 expression, 34 patients with EBV⁺DLBCL were categorized into CD30-positive and CD30-negative groups. Fisher exact test and Kaplan-Meier survival curves were employed to analyze the relationship between CD30 expression and clinicopathological parameters as well as its prognostic implications. Chi-square tests were used to compare the clinicopathological features between EBV⁺DLBCL and EBV^-DLBCL. Results: There were 19 males and 15 females with a median age of 69.5 (15-83) years in the EBV⁺DLBCL group. Compared with EBV^-DLBCL, EBV⁺DLBCL was more likely to present with clinical features such as B symptoms (χ²=23.818,P<0.001), Ann Arbor stage Ⅲ-Ⅳ (χ²=8.540,P=0.003), ECOG (Eastern Cooperative Oncology Group Performance Status) score 2-4 (χ²=6.722,P=0.010), IPI score 3-5 (χ²=9.953,P=0.002), and involvement of more than one extranodal site (χ²=6.825,P=0.009). Additionally, EBV⁺DLBCL exhibited higher frequencies of elevated LDH (χ²=4.307,P=0.038), CRP (χ²=5.596,P=0.018), and β2-MG (χ²=7.008,P=0.008) levels. Histopathologically, EBV⁺DLBCL was more commonly of the non-GCB subtype (χ²=12.421,P<0.001), with higher frequencies of CD30-positive (χ²=62.706,P<0.001),CD10-negative (χ²=8.687,P=0.003),bcl-6-negative (χ²=11.123,P<0.001), and bcl-2-negative (χ²=22.779,P=0.003) expression. Using 20% as the positive threshold for CD30, the CD30-positive group had a higher proliferation index (P=0.045). No significant differences were observed in overall survival between the two groups. Conclusions: EBV⁺DLBCL is more prevalent in the elderly and often exhibits aggressive clinical features. The expression of CD30 is not associated with the overall prognosis of EBV⁺DLBCL.