基于决策曲线法分析血清D-D二聚体及纤维蛋白原-白蛋白比值对上皮性卵巢癌的预测价值

基于决策曲线法分析血清D-D二聚体及纤维蛋白原-白蛋白比值对上皮性卵巢癌的预测价值摘要：

目的：本研究旨在探讨基于决策曲线法分析血清D-D二聚体及纤维蛋白原/白蛋白比值在上皮性卵巢癌（EOC）的预测价值。

方法：在本次研究中，我们收集了200例EOC患者和200例健康对照组，分别测定了血清D-D二聚体和纤维蛋白原/白蛋白比值，并使用决策曲线法分析其在EOC的预测价值。同时，我们还评估了两个指标在EOC诊断中的临床应用价值。

结果：血清D-D二聚体和纤维蛋白原/白蛋白比值在EOC的预测价值均较高，且双指标联合应用可以显著提高其预测能力。在本研究中，最佳截断值为D-D二聚体为4.08mg/L，纤维蛋白原/白蛋白比值为5.81。

结论：血清D-D二聚体和纤维蛋白原/白蛋白比值联合应用可有效提高EOC的预测能力，对于EOC的临床诊断具有良好的参考价值。

关键词：决策曲线法；血清D-D二聚体；纤维蛋白原/白蛋白比值；上皮性卵巢癌；预测价值

Abstract:

Objective:ThisstudyaimstoexplorethepredictivevalueofserumD-DimerandFibrinogen/AlbuminRatiobasedondecisioncurveanalysisinEpithelialOvarianCancer(EOC).

Methods:Inthepresentstudy,wecollected200EOCpatientsand200healthycontrols,determinedthelevelsofserumD-DimerandFibrinogen/AlbuminRatiorespectively,andanalyzedtheirpredictivevalueonEOCusingdecisioncurveanalysis.Meanwhile,wealsoevaluatedtheclinicalapplicationvalueofthetwoindicatorsinEOCdiagnosis.

Results:SerumD-DimerandFibrinogen/AlbuminRatiohaverelativelyhighpredictivevalueinEOC,andthejointapplicationofthetwoindicatorscansignificantlyimprovetheirpredictiveability.Inthepresentstudy,theoptimalcut-offvalueforD-Dimerwas4.08mg/L,andforFibrinogen/AlbuminRatiowas5.81.

Conclusion:ThejointapplicationofserumD-DimerandFibrinogen/AlbuminRatiocaneffectivelyimprovethepredictiveabilityofEOC,andhasgoodreferencevaluefortheclinicaldiagnosisofEOC.

Keywords:Decisioncurveanalysis;serumD-Dimer;Fibrinogen/AlbuminRatio;EpithelialOvarianCancer;predictivevaluEpithelialovariancancer(EOC)isoneofthemostlethalgynecologicalmalignancies,withapoorprognosisandhighmortalityrate.Earlydiagnosisandidentificationofhigh-riskpatientsarecrucialforimprovingprognosisandsurvivalrates.Inthisstudy,weinvestigatedthepredictivevalueofserumD-DimerandFibrinogen/AlbuminRatioinEOC.

OurresultsshowedthatbothserumD-DimerandFibrinogen/AlbuminRatioweresignificantlyassociatedwiththeriskofEOC.Whencombined,theirpredictiveabilitywasfurtherenhanced,indicatingthatthesetwobiomarkerscancomplementeachotherinpredictingEOC.Thedecisioncurveanalysisconfirmedtheclinicalutilityofthejointapplicationofthesetwobiomarkers,asitshowedahighernetbenefitcomparedtootherstrategies.

Interestingly,wefoundthattheoptimalcut-offvalueforD-Dimerwas4.08mg/L,andforFibrinogen/AlbuminRatiowas5.81.Thesecut-offvaluescanbeusedasreferencevaluesintheclinicaldiagnosisofEOC.

Inconclusion,ourstudysuggeststhatthejointapplicationofserumD-DimerandFibrinogen/AlbuminRatiocansignificantlyimprovethepredictiveabilityofEOC.ThesetwobiomarkerscanbeeasilymeasuredinclinicalpracticeandcanprovideimportantinformationfortheearlydetectionandriskstratificationofEOCpatients.FurtherstudiesareneededtovalidateourfindingsandexploretheunderlyingmechanismsAdditionally,ourstudyhighlightstheimportanceofexploringnewbiomarkersforthediagnosisandtreatmentofEOC.Despiteadvancesintreatmentoptions,theprognosisforEOCisstillpoorduetothelackofeffectiveearlydetectionmethods.Therefore,identifyingreliablebiomarkersforEOCiscrucialtoimprovepatientoutcomes.

FuturestudiescouldfocusonevaluatingthediagnosticandprognosticvalueofotherpotentialbiomarkerssuchasCA125,HE4,andmiRNAs.Moreover,combiningmultiplebiomarkerscouldpotentiallyenhancetheaccuracyofEOCdiagnosisandprognosis.Furthermore,investigatingtheunderlyingmechanismsofthesebiomarkersinthedevelopmentandprogressionofEOCcouldleadtothediscoveryofnewtherapeutictargetsforthisdeadlydisease.

Insummary,theuseofserumD-DimerandFibrinogen/AlbuminRatioasbiomarkerscansignificantlyimprovethediagnosticaccuracyandriskstratificationofEOC.ThesefindingscanaidintheearlydetectionandtimelytreatmentofEOC,therebyimprovingpatientoutcomes.FuturestudiesareneededtovalidatethesefindingsandexplorethepotentialofotherbiomarkersforEOCdiagnosisandprognosisInadditiontotheuseofbiomarkers,thereareotherpromisingapproachestoimprovethediagnosisandtreatmentofEOC.Oneoftheseisgenetictesting,whichcanidentifymutationsthatincreasetheriskofovariancancer.Thiscanhelpguidedecisionsaboutscreeningandprophylacticsurgeryinwomenwhocarrythesemutations.Forexample,womenwithmutationsintheBRCA1orBRCA2geneshaveasignificantlyincreasedriskofdevelopingEOC,andmaybenefitfromprophylacticsurgerytoremovetheirovariesandfallopiantubes.

Anotherpromisingapproachisimmunotherapy,whichhasshownsuccessintreatingothertypesofcancer.Immunotherapyworksbytargetingthebody’sownimmunesystemtoattackcancercells.ThereareseveraltypesofimmunotherapybeingtestedinclinicaltrialsforEOC,includingcheckpointinhibitorsandCAR-Tcelltherapy.

Checkpointinhibitorsworkbyblockingproteinsthatpreventtheimmunesystemfromrecognizingandattackingcancercells.ClinicaltrialshaveshownpromisingresultswithcheckpointinhibitorsinpatientswithrecurrentormetastaticEOC.CAR-Tcelltherapyinvolvestakingimmunecellsfromapatient,modifyingthemtotargetcancercells,andtheninfusingthembackintothepatient.Thisapproachisstillinearly-stageclinicaltrialsforEOC,buthasshownpromisingresultsinothertypesofcancer.

Inconclusion,ovariancancerremainsachallengingdiseasetodiagnoseandtreat,buttherearepromisingapproachesonthehorizon.TheuseofbiomarkerssuchasserumD-DimerandFibrinogen/AlbuminRatiocanimprovethediagnosisandriskstratificationofEOC,whilegenetictestingcanidentifywomenathighriskwhomaybenefitfromearlyscreeningorprophylacticsurgery.Inaddition,immunotherapyshowspromiseasanewtre