Development and Validation of Differential Diagnosis Models and Nomograms Based on Serum D-Dimer and Other Multimodal Information for Borderline and Benign Epithelial Ovarian Tumors: A Multicenter Study

Background: It is difficult to make a definite diagnosis of borderline epithelial ovarian tumors before surgery. In order to avoid incorrectly classifying tumors as benign, a differential diagnosis model was developed to distinguish between benign and borderline epithelial tumors utilizing multimodal information. Method: A multicenter study was conducted. A retrospective analysis of the transvaginal ultrasonography and clinical data of patients who underwent surgery and received pathological diagnoses of borderline and benign epithelial ovarian tumors was conducted. Both Univariate and multivariate logistic regression analyses were used to develop a diagnostic model for borderline epithelial tumors. The efficacy and feasibility of this model were assessed through examination of training, internal validation, and external test sets. Results: There was a significant difference in D-dimer levels between borderline and benign epithelial tumors. Abnormal CA125, D-dimer, maximum mass diameter > 10 cm, regular and irregular solid portions, and blood flow in the mass were independent risk factors for borderline epithelial ovarian tumors. The diagnostic model was evaluated by the Hosmer-Lemeshow test and demonstrated strong fitting capabilities. ROC curve analysis of the training set, verification set, and external test set confirmed the model's predictive ability. Conclusions: These independent risk factors may be combined to assess the risk of borderline epithelial ovarian tumors. Our findings will assist novice gynecologic sonographers in distinguishing between benign and borderline epithelial tumors.