通过机器学习来预测手术方法的影响和恶性植物瘤的存活率
Gongyin Zhang1, Foyan Xu2, Lixian Wan3
1Department of Breast Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China.
Updates in surgery
|April 7, 2025
概括
手术方法,包括乳房切除或乳房保护手术 (BCS),对乳房恶性乳腺瘤 (MPTB) 的长期存活率没有显著影响. 机器学习模型,特别是CatBoost,可以预测MPTB患者的生存结果.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 数据科学在医学中的数据科学
背景情况:
- 恶性乳腺瘤 (MPTB) 是罕见的,需要仔细规划治疗.
- 不同的外科手术方法对MPTB患者结局的影响尚未得到充分证实.
- 开发准确的预后模型对于个性化患者管理至关重要.
研究的目的:
- 评估手术方法 (乳房切除术与乳房保护手术) 对MPTB患者的存活率的影响.
- 为MPTB开发和验证基于机器学习的预测预测模型.
- 为了比较不同的机器学习算法在预测MPTB生存中的有效性.
主要方法:
- 从SEER数据库 (2000-2020) 中对MPTB患者 (18-80岁) 的回顾性分析.
- 倾向性得分匹配 (PSM) 减少共变量失衡.
- 考克斯比例危险回归和卡普兰-梅尔分析用于生存评估.
- 训练了10个机器学习模型,以预测乳腺癌5年特定存活率 (BCSS) 和整体存活率 (OS).
主要成果:
- 多变量考克斯分析表明,在MPTB患者的乳房切除和乳房保护手术 (BCS) 之间,长期生存结果没有显著差异 (p > 0.05).
- 这一发现甚至适用于病理类型较差的患者.
- CatBoost模型表现出优异的预测性能,在5年BCSS中达到0.8488的AUC,在5年OS中达到0.8512.
结论:
- 手术方法 (乳房切除与BCS) 不显著影响MPTB患者的长期存活率.
- 当可以实现足够的外科手术边缘时,BCS是一种可行的和首选的选择.
- CatBoost模型显示出作为指导MPTB管理中的系统性治疗决策的可靠工具的承诺.
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