目的 探讨血清可溶性CD276（sCD276）、甲壳质酶蛋白-40（YKL-40）、微小核糖核酸（miR）-152-5p、miR-193a-5p对高级别浆液性卵巢癌（HGSOC）患者预后的预测价值。 方法 选取2018年10月至2022年10月武汉市中西医结合医院妇科收治的240例HGSOC患者作为研究对象，所选患者均接受标准初始治疗，自初始治疗结束后开始接受为期3年的规律随访，随访截止至患者死亡或2025年10月31日。纳入的240例患者中，4例因失访被排除，最终纳入研究236例，根据患者3年随访记录分为预后不良组（71例）和预后良好组（165例）。比较预后不良组和预后良好组临床资料及血清sCD276、YKL-40、miR-152-5p、miR-193a-5p水平，分析HGSOC患者预后不良的危险因素，并绘制受试者工作特征（ROC）曲线分析血清sCD276、YKL-40、miR-152-5p、miR-193a-5p水平对HGSOC患者预后的预测价值。 结果 预后不良组有腹水、有淋巴结转移、有术后残余病灶占比及血清sCD276、YKL-40水平高于预后良好组（P < 0.05），血清miR-152-5p、miR-193a-5p水平低于预后良好组（P < 0.05）。有腹水、有淋巴结转移、有术后残余病灶及血清sCD276、YKL-40水平高是HGSOC患者预后不良的独立危险因素（P < 0.05），而血清miR-152-5p、miR-193a-5p水平高是保护因素（P < 0.05）。ROC分析结果显示，血清sCD276、YKL-40、miR-152-5p、miR-193a-5p水平联合检测预测HGSOC患者预后的AUC值为0.895，敏感度为88.73%，特异度为73.33%，联合检测的AUC值高于各指标单独检测（P < 0.05）。 结论 HGSOC预后不良患者血清sCD276、YKL-40水平呈高表达，而血清miR-152-5p、miR-193a-5p水平呈低表达，腹水、淋巴结转移、术后残余病灶及血清sCD276、YKL-40、miR-152-5p、miR-193a-5p水平均与患者预后密切相关，且血清sCD276、YKL-40、miR-152-5p、miR-193a-5p水平联合检测对HGSOC患者预后的预测价值更高。

Objective To investigate the predictive value of serum soluble CD276 （sCD276）， chitinase-3-like protein 1 （YKL-40）， microRNA （miR）-152-5p and miR-193a-5p in patients with high-grade serous ovarian cancer （HGSOC）. Methods A total of 240 patients with HGSOC admitted to the Department of Gynecology， Wuhan Hospital of Integrated Traditional Chinese and Western Medicine from October 2018 to October 2022 were selected as the study subjects. All selected patients received standard initial therapy and underwent regular follow-up for 3 years starting after completion of initial treatment. Follow-up continued until patient death or October 31， 2025. Among the 240 enrolled patients， 4 were excluded due to loss to follow-up， resulting in 236 patients included in the study. Based on 3-year follow-up records， patients were divided into poor prognosis group （71 cases） and good prognosis group （165 cases）. Clinical data and serum levels of sCD276， YKL-40， miR-152-5p， and miR-193a-5p in the poor prognosis and good prognosis groups were compared. The risk factors for poor prognosis in patients with HGSOC were analyzed. The predictive value of serum levels of sCD276， YKL-40， miR-152-5p， and miR-193a-5p in patients with HGSOC was assessed by ROC curves. Results The proportion of ascites， lymph node metastasis， and postoperative residual disease and serum levels of sCD276 and YKL-40 in the poor prognosis group were higher than the good prognosis group （P < 0.05）， serum levels of miR-152-5p and miR-193a-5p were lower than the good prognosis group （P < 0.05）. Ascites， lymph node metastasis， postoperative residual lesions and high levels of serum sCD276 and YKL-40 were independent risk factors for poor prognosis in patients with HGSOC （P < 0.05）， while high levels of serum miR-152-5p and miR-193a-5p were protective factors （P < 0.05）. ROC analysis revealed that the combined detection of serum sCD276， YKL-40， miR-152-5p， and miR-193a-5p in predicting the prognosis of HGSOC patients was 0.895， with a sensitivity of 88.73% and specificity of 73.33%， the combined detection AUC significantly exceeded that of individual markers （P < 0.05）. Conclusions The serum levels of sCD276 and YKL-40 in patients with poor prognosis of HGSOC were highly expressed， while the serum levels of miR-152-5p and miR-193a-5p were lowly expressed. Ascites， lymph node metastasis， postoperative residual lesions and serum levels of sCD276， YKL-40， miR-152-5p and miR-193a-5p were closely related to the prognosis of patients， and the combined detection of serum levels of sCD276， YKL-40， miR-152-5p and miR-193a-5p was more valuable in predicting the prognosis of patients with HGSOC.