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Background The expression of programmed death-ligand 1(PD-L1)and phosphorylation protein kinase B(p-AKT)are all associated with poor survival in diffuse large B-cell lymphoma(DLBCL).It is unknown whether there is correlation between PD-L1 and p-AKT in DLBCL.Methods 100 patients diagnosed with DLBCL were studied.PD-L1 and p-AKT protein expression were assessed by immunohistochemistry.Western blot and Flow cytometric were used to assay PD-L1 and mPD-L1 protein expression in DLBCL cell lines,respectively.Results Spearman test showed that PD-L1 expression was correlated with p-AKT expression(R = 0.244,x2 = 5.962; P = 0.017).Compared: co-expression of PDL1 and p-AKT protein to single positive expression and neither positive expression of PD-L1 and p-AKT protein,the combination of positive expression of both was associated with worst survival(P < 0.001).Multivariate Cox regression models showed that clinical stages(P = 0.016),chemotherapy regimens(P = 0.009),positive PD-L1 expression(P = 0.037)and positive p-AKT expression(P = 0.026)are independent prognostic factors negatively impacting survival.All of five DLBCL cell lines overexpress PD-L1 and mPD-L1 protein.Conclusions Co-expression of PD-L1 and p-AKT was associated with worse survival than positive PD-L1 expression or positive p-AKT expression.