CD30 expression in malignancy

CD30 expression has been investigated far less in solid tumors than in hematologic malignancies, with the exception of testicular embryonal carcinoma (EC).1,2,3 Testicular embryonal carcinoma is at present the one solid tumor in which CD30 is an accepted marker of the disease and is used as part of the standard diagnostic panel. There have been occasional reports of CD30 expression in various tumors of mesenchymal origin,4,5 cutaneous angiosarcoma,6,7 nasopharyngeal non-keratinizing carcinoma8 and other solid tumors,9 though the data are inconsistent and often not reproducible. In both solid tumors and hematologic malignancies, problems assessing CD30 expression include the evolution of diagnostic criteria over the years, use of different antibodies (eg, Ki-1 vs Ber-H2), use of frozen samples vs paraffin blocks, possible differences in the percentage of cells used to indicate positivity and incomplete data reporting. Standardization of protocols and reporting practices would substantially increase understanding of the expression and possible role of CD30 in these malignancies.

Various levels of CD30 expression have been reported in many tumor types. However, with the exceptions of HL, ALCL and testicular embryonal carcinoma, CD30 expression is generally supported by only a few studies with small numbers of patients. Additional studies are needed to determine whether this activation marker is instrumental in the malignant process or just a bystander, and whether CD30 expression affects clinical prognosis. Further characterizing the cell surface expression of CD30 might help identify subtypes or variants with clinical or prognostic significance. Finally, further characterization of CD30 may enable a better understanding of the pathogenesis of cancer, particularly the lymphomas.

CD30 was initially identified on the Reed-Sternberg (R-S) cells characteristic of HL.10 The German Hodgkin Study Group and others have found CD30 in >95% of cases of classical HL.11 In contrast, CD30 is expressed less intensely and in less than 10% of cases of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL), a histologic subtype that represents approximately 5% of all HL.12,13,14 CD30 is also highly expressed in ALCL.15,16 Cutaneous CD30-positive T-cell lymphoproliferative disorders, defined as having >75% of cells positive for CD30, include primary cutaneous anaplastic large cell lymphoma and lymphomatoid papulosis.17,18 CD30 expression has been studied extensively in HL and ALCL, but far less in other tumors. Some investigators have detected CD30, in different patterns and intensities, in several hematologic malignancies, including various T-cell lymphomas, subsets of B-cell lymphomas, immunoblastic lymphoma, multiple myeloma and adult T-cell lymphoma/leukemia.17,19 The literature reports CD30 expression on many T-cell15 and B-cell20 malignancies. Approximately 30% of T-cell and 15%-20% of B-cell lymphomas express CD30.21 In some of these tumor types, there is considerable support for CD30 expression, such as in peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS)22 and enteropathy-associated T-cell lymphoma.23 In others, such as multiple myeloma and acute myeloid leukemia/granulocytic sarcoma, there are small series or sometimes only case reports, underlining the need for more research in this area.24,25,26


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