A medical report containing terms like “CD10 positive” can be confusing. This article clarifies what CD10 is and its medical importance in identifying cell types and its associations with certain health conditions.
What is CD10?
CD10 is a protein found on the surface of some cells, acting as a marker. It is also known as Neutral Endopeptidase (NEP) or Common Acute Lymphoblastic Leukemia Antigen (CALLA). CD10 is a zinc-dependent metalloendopeptidase, an enzyme that breaks down certain peptides.
When cells are “CD10 positive,” it means this protein marker is present on their surface. The presence or absence of CD10 helps medical professionals characterize different cell types. This is important for diagnosing various diseases, as CD10 expression can vary significantly between healthy and diseased tissues.
CD10 in Normal Body Tissues
A “CD10 positive” result does not automatically indicate a disease, such as cancer. Many types of normal cells throughout the body naturally express the CD10 protein. This widespread presence highlights the importance of considering the specific location and context of CD10-positive cells during diagnosis.
CD10 is found on immature immune cells, such as early lymphoid progenitors in the bone marrow, and on follicular center cells within lymph nodes. Beyond the immune system, CD10 is also expressed on kidney cells (glomerular and proximal tubular cells), prostate gland cells, normal endometrial stromal cells in the uterus, and myoepithelial cells in the breast.
Association with Medical Conditions
The presence of CD10 on cells can be a significant indicator in the diagnosis and classification of various medical conditions, particularly certain types of cancer. Its expression patterns assist pathologists in distinguishing between different disease entities. However, CD10 is always considered as one piece of a larger diagnostic puzzle, alongside other markers, imaging results, and clinical symptoms.
Leukemias
CD10 is important in diagnosing acute lymphoblastic leukemia (ALL), especially B-lineage ALL. It is detected in blast cells in 94% to 95.6% of B-lineage ALL cases. In T-cell ALL, CD10 expression is less common, found in 18.1% to 40% of cases. CD10 helps characterize and classify these leukemias.
Lymphomas
CD10 is a used marker in diagnosing lymphomas originating from germinal center B-cells. It is frequently expressed in follicular lymphoma, with positivity from 89% to 100% of cases. In Burkitt lymphoma, an aggressive B-cell malignancy, CD10 is also positive. CD10 expression, along with other markers, helps differentiate these lymphomas from other B-cell lymphomas and reactive lymph node conditions.
CD10 can also be expressed in some diffuse large B-cell lymphomas (DLBCL), which can make differentiation from Burkitt lymphoma challenging. Less commonly, CD10 positivity has been observed in some mantle cell lymphomas, which usually lack this marker. Additional tests confirm the diagnosis in these cases.
Other Cancers
Beyond blood cancers, CD10 is associated with several solid tumors. Endometrial stromal sarcomas (ESS), rare malignant tumors of the uterus, almost always show strong positivity for CD10. This makes CD10 a helpful marker in distinguishing ESS from other uterine tumors, such as cellular leiomyomas, which are generally CD10 negative.
Renal cell carcinoma (RCC), particularly the conventional clear cell type, frequently expresses CD10, with positivity rates around 90% to 94%. Papillary RCC also shows CD10 expression, though in a lower percentage of cases (40% to 88%). CD10 staining patterns assist in differentiating RCC subtypes and distinguishing them from other kidney tumors like oncocytomas. CD10 expression has also been noted in some cases of hepatocellular carcinoma and certain melanomas, where it may correlate with advanced stages.
Role in Diagnosis and Prognosis
The detection of CD10 on cells uses specialized laboratory techniques. Two common methods are immunohistochemistry (IHC) and flow cytometry. Immunohistochemistry involves applying specific antibodies that bind to the CD10 protein in tissue samples, making the cells visible under a microscope. Flow cytometry analyzes cells suspended in a fluid, using fluorescently labeled antibodies to identify and quantify CD10-positive cells as they pass through a laser beam. Both techniques provide detailed immunophenotypic information.
The prognostic value of CD10 positivity varies significantly depending on the medical condition. In B-lineage acute lymphoblastic leukemia (ALL), CD10 expression is often associated with favorable clinical features, such as a lower white blood cell count at diagnosis. However, its independent prognostic significance in B-lineage ALL, particularly with modern treatments, is still being studied. Conversely, in T-cell ALL, the lack of CD10 expression has been independently associated with a less favorable prognosis.
For follicular lymphoma, strong CD10 expression has been associated with longer overall survival and time to treatment failure. In renal cell carcinomas, the pattern and extent of CD10 staining can also have prognostic implications; for instance, pure apical membranous staining in conventional RCC may be linked to lower tumor stage and improved prognosis. For endometrial stromal sarcomas, CD10 serves primarily as a diagnostic marker to help identify the tumor type, with its prognostic value being less defined compared to other factors like tumor grade and stage.