基于決策曲線法分析血清D-D二聚體及纖維蛋白原-白蛋白比值對上皮性卵巢癌的預測價值

基于決策曲線法分析血清D-D二聚體及纖維蛋白原-白蛋白比值對上皮性卵巢癌的預測價值摘要：

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）的預測價值。

方法：在本次研究中，我們收集了200例EOC患者和200例健康對照組，分別測定了血清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的預測價值。同時，我們還評估了兩個指標在EOC診斷中的臨床應用價值。

結果：血清D-D二聚體和纖維蛋白原/白蛋白比值在EOC的預測價值均較高，且雙指標聯(lián)合應用可以顯著提高其預測能力。在本研究中，最佳截斷值為D-D二聚體為4.08mg/L，纖維蛋白原/白蛋白比值為5.81。

結論：血清D-D二聚體和纖維蛋白原/白蛋白比值聯(lián)合應用可有效提高EOC的預測能力，對于EOC的臨床診斷具有良好的參考價值。

關鍵詞：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；預測價值

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