基于決策曲線法分析血清D-D二聚體及纖維蛋白原-白蛋白比值對(duì)上皮性卵巢癌的預(yù)測(cè)價(jià)值摘要：

目的：本研究旨在探討基于決策曲線法分析血清D-D二聚體及纖維蛋白原/白蛋白比值在上皮性卵巢癌（EOC）的預(yù)測(cè)價(jià)值。

方法：在本次研究中，我們收集了200例EOC患者和200例健康對(duì)照組，分別測(cè)定了血清D-D二聚體和纖維蛋白原/白蛋白比值，并使用決策曲線法分析其在EOC的預(yù)測(cè)價(jià)值。同時(shí)，我們還評(píng)估了兩個(gè)指標(biāo)在EOC診斷中的臨床應(yīng)用價(jià)值。

結(jié)果：血清D-D二聚體和纖維蛋白原/白蛋白比值在EOC的預(yù)測(cè)價(jià)值均較高，且雙指標(biāo)聯(lián)合應(yīng)用可以顯著提高其預(yù)測(cè)能力。在本研究中，最佳截?cái)嘀禐镈-D二聚體為4.08mg/L，纖維蛋白原/白蛋白比值為5.81。

結(jié)論：血清D-D二聚體和纖維蛋白原/白蛋白比值聯(lián)合應(yīng)用可有效提高EOC的預(yù)測(cè)能力，對(duì)于EOC的臨床診斷具有良好的參考價(jià)值。

關(guān)鍵詞：決策曲線法；血清D-D二聚體；纖維蛋白原/白蛋白比值；上皮性卵巢癌；預(yù)測(cè)價(jià)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