<![CDATA[Background: Diffuse large B-cell lymphoma (DLBCL) is an aggressive malignancy with heterogeneous outcomes, highlighting the need for accessible and reliable prognostic markers, particularly in resource-limited settings. Inflammation-based indices such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), together with the proliferation marker Ki-67, have been investigated as prognostic biomarkers; however, their prognostic value remains inconsistent across studies. Purpose: This study aimed to evaluate the prognostic value of baseline NLR, PLR, and Ki-67 expression for one-year overall survival in patients with DLBCL. Methods: A retrospective cohort study was conducted at Prof. Dr. I.G.N.G. Ngoerah General Hospital, Indonesia, involving 43 adult patients with histopathologically and immunohistochemically confirmed DLBCL. Overall survival was estimated using the Kaplan–Meier method, and differences between groups were assessed using the log-rank test. Associations between NLR, PLR, Ki-67 expression, and survival were evaluated using univariate Cox proportional hazards regression. Results: The one-year overall survival rate was 60.5%. NLR ≥4 was not significantly associated with survival (HR=0.802; p=0.664), while NLR ≥7.6 showed a higher but non-significant hazard of death (HR=2.374; p=0.107). Similarly, PLR ≥170 (HR=1.514; p=0.401) and PLR ≥213 (HR=1.909; p=0.191) were not significantly associated with survival. Among the evaluated Ki-67 cut-off values (70%, 80%, and 90%), only Ki-67 ≥90% was significantly associated with poorer one-year survival (HR=4.240; 95% CI: 1.470–12.260; p=0.008). Conclusion: Ki-67 expression ≥90% was the only evaluated biomarker significantly associated with poorer one-year overall survival in patients with DLBCL. These findings suggest that very high Ki-67 expression may have practical prognostic value for risk stratification, particularly in settings with limited access to advanced molecular diagnostics.]]>
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