新兴的生物亚群和新的预后标志物对于侵袭性弥漫性大 B 细胞淋巴瘤 (DLBCL) 非常重要。然而，高昂的检测成本限制了大多数医院进行这些检测的可能性，因此基于基本免疫组化检测、全血EB病毒DNA（WBEBV）监测和临床特征进行预后判断对于医疗条件较差的医院和患者来说是有利的。我们纳入了 2009 年 1 月至 2023 年 3 月期间在我们医院接受治疗的 647 名 DLBCL 患者。非生发中心 B 细胞样、Ki-67 和国际预后指数 (IPI) 评分与 cMYC/B 细胞淋巴瘤 2 (Bcl- 2)-双重表达。年龄、Epstein-Barr 病毒编码的小 RNA (EBER) 阳性和 IPI 评分与死亡率相关。年龄、WBEBV、Bcl-2 和 cMYC 差异总生存 (OS) 的截止值分别为 57 岁、1514 拷贝/mL（基线）、5.89×104 拷贝/mL（治疗）、40% 和 55% 。 EBER 阳性与较差的操作系统显着相关。新定义的 DE（Bcl-2 ≥40 和 cMYC > 55）患者的预后比对照组更差（p = 0.04）。我们发现cMYC的最佳截断值为47.5，可以有效预测高级别DLBCL，曲线下面积为0.912，特异性和敏感性分别为70.7%和100%。我们的研究为影响 DLBCL 患者 OS 的预后因素和生物标志物临界值提供了宝贵的见解，这可以指导临床医生制定治疗策略并改善患者的治疗结果。© 2024 Wiley periodicals LLC。

Emerging biologic subsets and new prognostic markers are significantly important for aggressive diffuse large B-cell lymphoma (DLBCL). Nevertheless, the high cost of testing limits the availability of these tests in most hospitals, thus making prognostic judgment based on basic immunohistochemical testing, whole blood Epstein-Barr virus DNA (WBEBV) surveillance and clinical features advantageous for hospitals and patients with poor medical conditions. We included 647 DLBCL patients treated in our hospital from January 2009 to March 2023. Non-germinal center B-cell like, Ki-67, and International Prognostic Index (IPI) scores were related to cMYC/B-cell lymphoma 2 (Bcl-2)-double expression. Age, Epstein-Barr virus-encoded small RNA (EBER) positivity, and IPI scores were associated with mortality. The cutoffs for differential overall survival (OS) of age, WBEBV, Bcl-2, and cMYC were 57 years, 1514 copies/mL (baseline), 5.89 × 104 copies/mL (treatment), 40%, and 55%, respectively. EBER positivity was significantly associated with a worse OS. Patients with newly defined DE (Bcl-2 ≥ 40 and cMYC > 55) had a worse prognosis than controls (p = 0.04). We found that cMYC with an optimal cutoff of 47.5 could effectively predict high-grade DLBCL with an area under the curve of 0.912, and the specificity and sensitivity were 70.7% and 100%, respectively. Our study provides valuable insights into the prognostic factors and biomarker cutoffs that influence OS in DLBCL patients, which may guide clinicians in tailoring treatment strategies and improving patient outcomes.© 2024 Wiley Periodicals LLC.