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However, it is heterogenous, and the prognosis is poor if the tumor cells harbor fusions involving <jats:italic>MYC<\/jats:italic> and <jats:italic>BCL2<\/jats:italic> or <jats:italic>MYC<\/jats:italic> and <jats:italic>BCL6<\/jats:italic> (double\u2010hit [DH] lymphoma), or fusions involving all three genes (triple\u2010hit [TH] lymphoma). Fluorescence <jats:italic>in situ<\/jats:italic> hybridization is currently the gold standard for confirming the presence of DH\/TH genotypes. However, the test is laborious and not readily available in some laboratories. Germinal center B (GCB) signatures and dual expression of MYC and BCL2 are commonly used as initial screening markers (traditional model) in clinical practice. Our study proposes immunohistochemical markers for more conveniently and accessibly screening DH\/TH genotypes in DLBCL. We retrospectively reviewed the clinical and pathological parameters of patients with DLBCL. We assessed the proliferative index, apoptotic index, and tumor microenvironment (TME), with regard to T cells and CD11c(+) dendritic cells, in formalin\u2010fixed paraffin\u2010embedded tissue. We then generated a decision tree as a screening algorithm to predict DH\/TH genotypes and employed decision curve analysis to demonstrate the superiority of this new model in prediction. We also assessed the prognostic significance of related parameters. Our study revealed that GCB subtypes, a Ki67 proliferative index higher than 70%, and BCL2 expression were significantly associated with DH\/TH genotypes. Decreased CD11c(+) dendritic cells in the TME indicated additional risk. Our proposed screening algorithm outperformed a traditional model in screening for the DH\/TH genotypes. In addition, decreased CD11c(+) dendritic cells in the DLBCL TME were an independent unfavorable prognosticator. In conclusion, we provide a convenient, well\u2010performing model that predicts DH\/TH genotypes in DLBCL. The prognostic significance of CD11c(+) dendritic cells in the TME might influence the classification and development of immunotherapy for DLBCL in the future.<\/jats:p>","DOI":"10.1002\/cjp2.283","type":"journal-article","created":{"date-parts":[[2022,6,18]],"date-time":"2022-06-18T01:05:16Z","timestamp":1655514316000},"page":"436-447","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Decreased <scp>CD11c<\/scp>\u2010positive dendritic cells in the tumor microenvironment predict double\u2010hit\/triple\u2010hit genotype and survival in diffuse large B\u2010cell lymphoma"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1438-9187","authenticated-orcid":false,"given":"Chang\u2010Tsu","family":"Yuan","sequence":"first","affiliation":[{"name":"Graduate Institute of Clinical Medicine National Taiwan University College of Medicine  Taipei Taiwan"},{"name":"Department of Pathology National Taiwan University Cancer Center  Taipei Taiwan"},{"name":"Department of Pathology National Taiwan University Hospital and National Taiwan University College of Medicine  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih\u2010Sung","family":"Chuang","sequence":"additional","affiliation":[{"name":"Department of Pathology Chi\u2010Mei Medical Center  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei\u2010Yuan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Pathology National Taiwan University Hospital and National Taiwan University College of Medicine  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koping","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Pathology National Taiwan University Hospital and National Taiwan University College of Medicine  Taipei Taiwan"},{"name":"Graduate Institute of Pathology National Taiwan University College of Medicine  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology National Taiwan University Hospital Hsin\u2010Chu Branch  Hsinchu Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Huei","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Pathology National Taiwan University Hospital and National Taiwan University College of Medicine  Taipei Taiwan"},{"name":"Graduate Institute of Pathology National Taiwan University College of Medicine  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jau\u2010Yu","family":"Liau","sequence":"additional","affiliation":[{"name":"Department of Pathology National Taiwan University Hospital and National Taiwan University College of Medicine  Taipei Taiwan"},{"name":"Graduate Institute of Pathology National Taiwan University College of Medicine  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Chien","family":"Chou","sequence":"additional","affiliation":[{"name":"Graduate Institute of Clinical Medicine National Taiwan University College of Medicine  Taipei Taiwan"},{"name":"Department of Laboratory Medicine National Taiwan University Hospital  Taipei Taiwan"},{"name":"Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of Medicine  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,17]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues","author":"Swerdlow SH","year":"2017"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.09.137"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-12-820605"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.21037\/aol.2018.11.01"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.41.0985"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12982"},{"key":"e_1_2_7_8_1","unstructured":"National Comprehensive Cancer Network.B\u2010Cell Lymphomas (Version 4.2021).2021. 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