可解释的机器学习用于预测存活率和风险分层在乳腺癌的老年患者乳腺保护手术后的风险分层
1Department of Thyroid and Breast Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, China.
Gland surgery
|March 11, 2026
概括
机器学习模型在手术后的老年早期乳腺癌患者中识别出不同的生存组. 这有助于通过分层风险来个性化治疗,可能减少不必要的辅助放射治疗.
科学领域:
- 在瘤学瘤学.
- 机器学习 机器学习
- 生物统计学 生物统计学
背景情况:
- 对老年早期乳腺癌的乳腺保护手术 (BCS) 后辅助放射治疗的必要性进行了辩论.
- 现有的研究缺乏预后子组,以定制治疗决策.
- 重点是对人口的好处,而不是个人生存概率.
研究的目的:
- 开发可解释的机器学习模型,用于对老年乳腺癌患者的生存预测.
- 为个性化治疗讨论建立精确的预后风险分层.
- 在BCS之后,就辅助性放射治疗做出明智的决定.
主要方法:
- 使用的监测,流行病学和最终结果 (SEER) 数据库 (2016-2022).
- 包括70岁以上的T1-2N0M0,ER+,HER2-乳腺癌患者进行BCS.
- 开发并评估了六种机器学习生存模型,使用SHAP进行解释和Kaplan-Meier进行风险分层.
主要成果:
- 该XGBoost模型显示最佳性能 (5年AUC:0.711).
- 确定了关键预测因素:年龄,瘤等级和T阶段.
- 将患者分层分为低 (88-90% 5年生存期),中等 (82-84% 5年生存期) 和高风险 (65-67% 5年生存期) 组 (P<0.001).
结论:
- 成功开发了一个预后风险分层系统,用于老年早期乳腺癌患者.
- 低风险组的生存率 (88-90%的5年生存率) 反映了放射治疗的结果.
- 该系统有助于进行个性化治疗讨论,但需要进行前性验证.
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