在未来的多中心队列中进行非内镜巴雷特食道检测测试的算法训练和测试
Prasad G Iyer1, Seth W Slettedahl2, Douglas W Mahoney2
1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
概括
使用非内镜细胞采集装置 (CCD) 的新型3甲基化DNA标记 (MDM) 面板算法显示,检测巴雷特食道 (BE) 和食道腺癌 (EAC) 的精度很高. 这种非侵入性测试为高风险的BE病例提供了极好的灵敏度.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 分子诊断学 分子诊断学
背景情况:
- 对巴雷特食道 (BE) 和食道腺癌 (EAC) 的内镜检测是侵入性的和昂贵的.
- 非内镜方法是指导方针推的BE/EAC检测替代方法.
- 一个先前开发的5甲基化DNA标记物 (MDM) 面板使用了细胞采集装置 (CCD) 标本.
研究的目的:
- 训练和验证使用3MDM面板用于BE/EAC检测的新算法.
- 在独立的队列中评估3-MDM面板算法的性能.
- 为BE和EAC建立一个不那么侵入性的诊断工具.
主要方法:
- 算法训练和测试是在两个潜在的多中心队列的样本上进行的.
- 从通过CCD收集的细胞溶解物中提取DNA,处理双硫酸盐,并对MDM进行测试.
- 通过交叉验证训练和锁定了一个后勤回归模型,然后在一个独立的数据集上进行测试.
主要成果:
- 最后的3MDM小组 (NDRG4,VAV3,ZNF682) 在训练和测试组中都表现出高灵敏度和特异性.
- 对BE检测的总体灵敏度为82%-88%,对高度发育不良和EAC的100%灵敏度.
- 接收器运行特征曲线 (0.92-0.94) 下的区域表明强大的诊断性能.
结论:
- 使用非内镜CCD的经过验证的3-MDM面板算法显示了用于检测高风险BE的卓越灵敏度.
- 这种非侵入性方法为BE/EAC查和诊断提供了一个有希望的工具.
- 这项研究提供了强有力的证据,证明这种新型诊断方法的临床实用性.
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