Prostate:机器学习算法可以更有效地预测机器人辅助根治性前列腺切除术后的生化复发情况

2021-07-18 AlexYang MedSci原创

计算机记录的电子医疗数据已经形成了大量知识的积累。这些数据在已在临床实践中使用,现代医学也随之发展。机器学习(ML)方法是在统计学、计算机科学和人工智能(AI)的基础上发展起来的,它通过解析更复杂的关

计算机记录的电子医疗数据已经形成了大量知识的积累。这些数据在已在临床实践中使用,现代医学也随之发展。机器学习(ML)方法是在统计学、计算机科学和人工智能(AI)的基础上发展起来的,它通过解析更复杂的关系和关系模式,促进了新的和更方便的算法的构建,而这些关系和模式在传统统计方法中是无法在大型数据库中揭示的。

近期,有研究人员利用临床参数和机器学习(ML)方法建立了一个预测长期随访患者生化复发(BCR)的模型

研究人员对2014年1月至2019年12月期间接受机器人辅助根治性前列腺切除术的患者进行了回顾。没有BCR的患者分配到第一组,而诊断为BCR的患者分配到第二组。 患者的人口统计学数据、术前和术后参数都记录在数据库中,并采用了三种不同的ML算法:随机森林、K-最近邻和逻辑回归。

研究包括了368名患者。在这些患者中,295人(80.1%)没有BCR(第一组),73人(19.8%)有BCR(第二组)。随访的平均时间和直到诊断出BCR的时间分别为35.2±16.7和11.5±11.3个月。多变量分析显示,NLR、PSAd、风险分类、PIRADS评分、T分期、有无手术边缘阳性和精囊侵犯对BCR有预测作用。经典的Cox回归分析的曲线下面积(AUC)为0.915,敏感性和特异性为90.6%和79.8%。随机森林、K最近邻和逻辑回归的接收器操作特征曲线的AUC分别为0.95、0.93和0.93。所有ML模型在预测前列腺切除术后的BCR方面都优于传统的统计回归模型。

机器学习算法的AUC

综上所述,构建更可靠和有效的模型将为临床医生和患者提供更准确的风险分类、预后估计、早期干预、避免不必要的治疗、相对降低发病率和死亡率等优势ML方法成本低廉,而且其能力随着数据输入的增加而增加;我们相信随着时间的推移,其临床应用会越来越多。

原始出处:

Mithat Ekşi, İsmail Evren, Fatih Akkaş et al. Machine learning algorithms can more efficiently predict biochemical recurrence after robot-assisted radical prostatectomy. Prostate. Jul 2021

 

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    2021-07-20 xue8602
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12:40:14 CST 2021, time=2021-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1000733, encodeId=214c1000e33f3, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqH9rugpZngCJRbK3JJHAofGwbdxQ4c7oBXSb6g3mywgSpcne8RAK2vzvO5kNafLiaAJibtJict7vVtQ/132, createdBy=9cb42348116, createdName=122a5e7dm85暂无昵称, createdTime=Sun Jul 18 23:19:40 CST 2021, time=2021-07-18, status=1, ipAttribution=)]
    2021-07-20 lsndxfj
  5. 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12:40:14 CST 2021, time=2021-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1000733, encodeId=214c1000e33f3, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqH9rugpZngCJRbK3JJHAofGwbdxQ4c7oBXSb6g3mywgSpcne8RAK2vzvO5kNafLiaAJibtJict7vVtQ/132, createdBy=9cb42348116, createdName=122a5e7dm85暂无昵称, createdTime=Sun Jul 18 23:19:40 CST 2021, time=2021-07-18, status=1, ipAttribution=)]
  6. 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  7. 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12:40:14 CST 2021, time=2021-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1000733, encodeId=214c1000e33f3, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqH9rugpZngCJRbK3JJHAofGwbdxQ4c7oBXSb6g3mywgSpcne8RAK2vzvO5kNafLiaAJibtJict7vVtQ/132, createdBy=9cb42348116, createdName=122a5e7dm85暂无昵称, createdTime=Sun Jul 18 23:19:40 CST 2021, time=2021-07-18, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1877452, encodeId=406418e745201, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Sat May 21 01:40:14 CST 2022, time=2022-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1708888, encodeId=37741e08888fa, content=<a href='/topic/show?id=ffca32501e6' target=_blank style='color:#2F92EE;'>#前列腺切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32501, encryptionId=ffca32501e6, topicName=前列腺切除)], attachment=null, authenticateStatus=null, createdAvatar=null, 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12:40:14 CST 2021, time=2021-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1000733, encodeId=214c1000e33f3, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqH9rugpZngCJRbK3JJHAofGwbdxQ4c7oBXSb6g3mywgSpcne8RAK2vzvO5kNafLiaAJibtJict7vVtQ/132, createdBy=9cb42348116, createdName=122a5e7dm85暂无昵称, createdTime=Sun Jul 18 23:19:40 CST 2021, time=2021-07-18, status=1, ipAttribution=)]
    2021-07-20 jeanqiuqiu
  9. 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12:40:14 CST 2021, time=2021-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1000733, encodeId=214c1000e33f3, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqH9rugpZngCJRbK3JJHAofGwbdxQ4c7oBXSb6g3mywgSpcne8RAK2vzvO5kNafLiaAJibtJict7vVtQ/132, createdBy=9cb42348116, createdName=122a5e7dm85暂无昵称, createdTime=Sun Jul 18 23:19:40 CST 2021, time=2021-07-18, status=1, ipAttribution=)]
    2021-07-20 sunylz
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    2021-07-18 122a5e7dm85暂无昵称

    学习

    0

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老年人在接受各种肿瘤治疗时,认知能力下降的风险更大。一些常用的晚期前列腺癌治疗方法,如恩杂鲁胺,与认知障碍有关,但已公布的数据很少,这些数据来自单组研究或关注在自我报告的认知上。

BJU Int:根治性前列腺切除术中阳性手术边缘分类的临床应用

在根治性前列腺切除术(RP)样本中发现手术边缘阳性(PSM)意味着生化复发(BCR)的风险增加一倍。手术边缘状态包括两种,即阳性与阴性。在过去的十年中,人们越来越关注进一步的分类,包括PSM的数量、位

NEJM:磁共振成像可增加前列腺癌检出率并减少“过度诊断”

每年大约有 140 万男性被诊断出前列腺癌,375,000 人死于该疾病。先前有研究表明,早筛可以提早发现前列腺癌指证,从而降低前列腺癌死亡的风险。

J Urol:5-α还原酶抑制剂对MRI检测前列腺癌的影响

5-α还原酶抑制剂(5-ARIs)非那雄胺和度他雄胺是治疗继发于良性前列腺增生的下尿路症状的有效治疗方法,可降低急性尿潴留的风险,并减少前列腺增生男性对手术干预的需要。通过阻断5-&alp

Nat Commun:EZH2甲基化ERG K362位点并增强前列腺癌中TMPRSS2-ERG的致癌活性

ETS转录因子是一类控制细胞增殖、分化和致癌作用的信号依赖性转录调节因子家族。