arXiv:2409.00163cs.LGcs.AI2024-09被引 1

用深度神经网络预测食管癌术后复发与生存,效果优于传统模型。

Deep Neural Networks for Predicting Recurrence and Survival in Patients with Esophageal Cancer After Surgery

  • 采用Cox模型和两种深度神经网络(DeepSurv、DeepHit)分析预后因素
  • DeepSurv在无病生存和总生存预测上分别达到0.735和0.74的C指数
  • 病理特征比临床分期更具预测价值,适合临床风险分层应用

食管癌是全球范围内导致癌症死亡的主要原因,即使接受根治性手术治疗,仍存在高复发率和低生存率。明确相关预后因素并预测预后,有助于优化术后临床决策,改善患者结局。本研究基于ENSURE多中心国际队列数据,评估了三种模型在无病生存(DFS)和总生存(OS)预测中的表现。首先使用Cox比例风险模型分析各特征的影响,随后采用CoxPH及两种基于深度神经网络(DNN)的模型(DeepSurv与DeepHit)进行预测。模型识别出的显著预后因素与临床文献一致,术后病理特征的重要性高于临床分期。DeepSurv与DeepHit在预测性能上与CoxPH相当,其中DeepSurv在两任务中略优,分别取得0.735和0.74的C指数。结果表明,深度神经网络具备提升预测精度与实现个性化风险分层的潜力,但当前数据下CoxPH仍是表现良好的基准模型。

原文摘要 · Abstract (English)

Esophageal cancer is a major cause of cancer-related mortality internationally, with high recurrence rates and poor survival even among patients treated with curative-intent surgery. Investigating relevant prognostic factors and predicting prognosis can enhance post-operative clinical decision-making and potentially improve patients' outcomes. In this work, we assessed prognostic factor identification and discriminative performances of three models for Disease-Free Survival (DFS) and Overall Survival (OS) using a large multicenter international dataset from ENSURE study. We first employed Cox Proportional Hazards (CoxPH) model to assess the impact of each feature on outcomes. Subsequently, we utilised CoxPH and two deep neural network (DNN)-based models, DeepSurv and DeepHit, to predict DFS and OS. The significant prognostic factors identified by our models were consistent with clinical literature, with post-operative pathologic features showing higher significance than clinical stage features. DeepSurv and DeepHit demonstrated comparable discriminative accuracy to CoxPH, with DeepSurv slightly outperforming in both DFS and OS prediction tasks, achieving C-index of 0.735 and 0.74, respectively. While these results suggested the potential of DNNs as prognostic tools for improving predictive accuracy and providing personalised guidance with respect to risk stratification, CoxPH still remains an adequately good prediction model, with the data used in this study.

食管癌生存预测深度学习风险分层

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