使用机器学习模型优化复发风险/Prosigna测试指南:瑞典多中心研究
Una Kjällquist1, Nikos Tsiknakis2, Balazs Acs1
1Department of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden; Theme Cancer, Karolinska University Hospital, Stockholm, Sweden.
Breast (Edinburgh, Scotland)
|May 10, 2025
概括
机器学习改善了对激素受体阳性,HER2阴性乳腺癌的基因表达概况的患者选择. 这种方法提高了风险分层的准确性,并减少了对复发风险 (ROR) /Prosigna测试的不必要测试.
科学领域:
- 在瘤学瘤学.
- 生物信息学是一种生物信息学.
- 机器学习 机器学习
背景情况:
- 基因表达造型有助于治疗辅助激素受体阳性,HER2阴性乳腺癌的治疗决策.
- 现有的优化算法专注于RS/Oncotype Dx,而不是ROR/Prosigna试验.
- 准确的患者选择基因组测试对于优化辅助治疗至关重要.
研究的目的:
- 开发和验证一种机器学习模型,以加强对ROR/Prosigna测试患者的预选.
- 提高HR+/HER2-乳腺癌风险分层的准确性.
- 通过更好的预选,减少需要ROR/Prosigna测试的患者数量.
主要方法:
- 在348名绝经后妇女中,使用预后因素 (瘤大小,孕激素受体表达,等级,Ki67) 开发了一种机器学习模型.
- 该模型预测了切除HR+/HER2-节点阴性乳腺癌患者的ROR/Prosigna输出.
- 绩效与现有的风险分层方案进行了比较,这些风险分层方案涉及过度治疗和治疗不足.
主要成果:
- 机器学习模型表现出强大的预测性能,AUC为0.77 (训练) 和0.83 (验证),用于预测化疗指示.
- 经验证的上下切线改善了低风险,中等风险和高风险疾病的风险分层精度.
- 与当前方法相比,该模型显著降低了需要ROR/Prosigna测试的患者比例.
结论:
- 机器学习算法可以有效地提高患者对基因表达造型的选择.
- 开发的模型改善了风险分层,并减少了对ROR/Prosigna的不必要测试.
- 建议进行进一步的外部验证,以确认这些发现的概括性.
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