机器学习和考克斯回归模型的比较,用于远程转移肝细胞癌患者的预后分析
Hailan Li1, Junbo Wang1, Xin Ming1,2,3
1Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China.
Surgery open science
|July 14, 2025
概括
对于具有远程转移 (DM) 的晚期肝细胞癌 (HCC) 的准确预后至关重要. 考克斯回归和随机生存森林模型在预测生存方面表现强,考克斯回归提供了更好的稳定性.
科学领域:
- 在瘤学瘤学.
- 医疗信息学 医疗信息学
- 生物统计学 生物统计学
背景情况:
- 晚期肝细胞癌 (HCC) 的存活率在新的治疗方法下有所改善.
- 远程转移 (DM) 患者的准确预后对于治疗和管理至关重要.
- 确定预后因素是改善HCC患者生活质量的关键.
研究的目的:
- 确定DM的HCC患者整体存活期的独立预后因素.
- 评估各种模型的性能,包括考克斯回归和机器学习,用于预测转移性HCC的存活率.
- 在这个患者群体中开发一种生存分层的工具.
主要方法:
- 从监测,流行病学和最终结果数据库中提取了3051名患有DM的HCC患者的数据.
- 使用单变量和多变量考克斯回归来确定预后因素.
- 与使用AUC,决策曲线分析,校准曲线和Brier分数的Cox回归,DeepSurv,决策树和随机生存森林模型进行比较.
主要成果:
- 确定瘤大小,肺转移,N期,化疗,放射治疗,AFP,纤维化,治疗间隔和转移数量作为独立的预后因素.
- 考克斯回归和随机生存森林模型表现出强的性能,AUC在3,6和12个月时约为0.74-0.76.
- 考克斯回归显示,6个月和12个月的Brier分数最低,表明精确度更高.
结论:
- 考克斯回归和随机生存森林模型对于HCC预后是有效的.
- 考克斯回归为转移性HCC的生存预测提供了卓越的时间稳定性.
- 基于Cox的诺米图可以直观地对转移性HCC患者在3,6和12个月的存活率进行分层.
相关概念视频
Comparing the Survival Analysis of Two or More Groups
292
Survival analysis is a cornerstone of medical research, used to evaluate the time until an event of interest occurs, such as death, disease recurrence, or recovery. Unlike standard statistical methods, survival analysis is particularly adept at handling censored data—instances where the event has not occurred for some participants by the end of the study or remains unobserved. To address these unique challenges, specialized techniques like the Kaplan-Meier estimator, log-rank test, and...
292
Cancer Survival Analysis
456
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
456
The Mantel-Cox Log-Rank Test
572
The Mantel-Cox log-rank test is a widely used statistical method for comparing the survival distributions of two groups. It tests whether a statistically significant difference exists in survival times between the groups without assuming a specific distribution for the survival data, making it a non-parametric test. This flexibility makes the log-rank test particularly valuable in medical research and other fields where the timing of an event, such as death or disease recurrence, is of...
572
Kaplan-Meier Approach
274
The Kaplan-Meier estimator is a non-parametric method used to estimate the survival function from time-to-event data. In medical research, it is frequently employed to measure the proportion of patients surviving for a certain period after treatment. This estimator is fundamental in analyzing time-to-event data, making it indispensable in clinical trials, epidemiological studies, and reliability engineering. By estimating survival probabilities, researchers can evaluate treatment effectiveness,...
274


