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

<b>Objective:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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 (<i>χ</i>²=23.818,<i>P</i><0.001), Ann Arbor stage Ⅲ-Ⅳ (<i>χ</i>²=8.540,<i>P</i>=0.003), ECOG (Eastern Cooperative Oncology Group Performance Status) score 2-4 (<i>χ</i>²=6.722,<i>P</i>=0.010), IPI score 3-5 (<i>χ</i>²=9.953,<i>P</i>=0.002), and involvement of more than one extranodal site (<i>χ</i>²=6.825,<i>P</i>=0.009). Additionally, EBV⁺DLBCL exhibited higher frequencies of elevated LDH (<i>χ</i>²=4.307,<i>P</i>=0.038), CRP (<i>χ</i>²=5.596,<i>P</i>=0.018), and β2-MG (<i>χ</i>²=7.008,<i>P</i>=0.008) levels. Histopathologically, EBV⁺DLBCL was more commonly of the non-GCB subtype (<i>χ</i>²=12.421,<i>P</i><0.001), with higher frequencies of CD30-positive (<i>χ</i>²=62.706,<i>P</i><0.001),CD10-negative (<i>χ</i>²=8.687,<i>P</i>=0.003),bcl-6-negative (<i>χ</i>²=11.123,<i>P</i><0.001), and bcl-2-negative (<i>χ</i>²=22.779,<i>P</i>=0.003) expression. Using 20% as the positive threshold for CD30, the CD30-positive group had a higher proliferation index (<i>P</i>=0.045). No significant differences were observed in overall survival between the two groups. <b>Conclusions:</b> 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.