用改进的关联规则挖掘出甲状腺乳头癌的潜在恶性征象。
Interpretable Data Mining of Follicular Thyroid Cancer Ultrasound Features Using Enhanced Association Rules
- 改进关联规则算法，结合SHAP思想量化临床特征与恶性的关联强度。
- 发现结节内结节、网状结构、低TSH等特征与恶性高度相关。
- 研究结果可为术前诊断提供可解释的参考依据，适合临床医生使用。
甲状腺癌是常见癌症，其中滤泡状甲状腺癌缺乏特异性超声表现，术前诊断难度高于乳头状甲状腺癌，相关临床研究也较不充分。本研究基于北京大学第三医院2010至2023年收集的病例数据，采用改进的关联规则挖掘方法，突破传统统计分析局限，引入可解释机器学习中的SHAP思想，构建新指标以反映临床指征与恶性之间的关联强度。数据经预处理后共包含1673个结节（非患者个体），其中良性结节1414个，恶性结节259个。分析发现，除常见恶性征象（如边缘不规则、分叶状、厚薄不均包膜、低回声外），还识别出结节内结节模式、网状结构及低TSH水平等具有强恶性关联的特征；此外，合并桥本甲状腺炎也可能显著提示恶性风险。研究强调，在术前评估可疑滤泡状甲状腺癌结节时，应综合多种临床指征进行判断，所揭示的多重恶性关联可为相关临床决策提供可解释性参考。
原文摘要 · Abstract (English)
Purpose: Thyroid cancer has been a common cancer. Papillary thyroid cancer and follicular thyroid cancer are the two most common types of thyroid cancer. Follicular thyroid cancer lacks distinctive ultrasound signs and is more difficult to diagnose preoperatively than the more prevalent papillary thyroid cancer, and the clinical studies associated with it are less well established. We aimed to analyze the clinical data of follicular thyroid cancer based on a novel data mining tool to identify some clinical indications that may help in preoperative diagnosis. Methods: We performed a retrospective analysis based on case data collected by the Department of General Surgery of Peking University Third Hospital between 2010 and 2023. Unlike traditional statistical methods, we improved the association rule mining, a classical data mining method, and proposed new analytical metrics reflecting the malignant association between clinical indications and cancer with the help of the idea of SHAP method in interpretable machine learning. Results: The dataset was preprocessed to contain 1673 cases (in terms of nodes rather than patients), of which 1414 were benign and 259 were malignant nodes. Our analysis pointed out that in addition to some common indicators (e.g., irregular or lobulated nodal margins, uneven thickness halo, hypoechogenicity), there were also some indicators with strong malignant associations, such as nodule-in-nodule pattern, trabecular pattern, and low TSH scores. In addition, our results suggest that the combination of Hashimoto's thyroiditis may also have a strong malignant association. Conclusion: In the preoperative diagnosis of nodules suspected of follicular thyroid cancer, multiple clinical indications should be considered for a more accurate diagnosis. The diverse malignant associations identified in our study may serve as a reference for clinicians in related fields.
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