arXiv:2606.08538cs.LG2026-06

用血液检测轨迹提前预测癌症治疗并发症,效果优于传统方法。

Routine laboratory trajectories encode the onset of organ-level complications in cancer

论文配图:Routine laboratory trajectories encode the onset of organ-level complications in cancer
图 1 · 摘自论文原文
  • 用Transformer模型分析长期血液数据,捕捉器官功能变化
  • 提前数周至数月预测162种并发症,组内风险提升1.5至6.1倍
  • 跨癌种、跨系统验证有效,适合临床早期预警场景

癌症治疗期间常规实验室检查构成器官功能的纵向生理记录,但单时间点预测工具忽略了其时间结构。一个基于3,905名多发性骨髓瘤或卵巢癌患者277万条实验室数据训练的Transformer模型,成功预测了两年内162种与治疗相关的并发症(涵盖8类临床问题),包括化疗相关骨髓增生异常综合征,在群体层面风险提升1.5至6.1倍。该模型在分组终点上的表现匹配或优于非序列基线(AUROC最高提升+0.11),证明纵向实验室轨迹可捕获孤立测量无法反映的特异性生理变化。预测结果在两种癌症间具有泛化能力,疾病特异性差异集中于特定并发症;生物标志物遮蔽后恢复出符合已知病理生理学的信号。在MIMIC-IV和MMRF CoMMpass数据集上的外部验证确认了其在不同医疗系统间的可迁移性(最高AUROC达0.85)。常规肿瘤实验室数据可在临床症状出现前数周至数月反映器官损伤,实现无需额外检测设备的并发症特异性监测。

原文摘要 · Abstract (English)

Routine laboratory panels drawn during cancer treatment constitute longitudinal physiological recordings of organ function, yet their temporal structure is discarded by single-timepoint prognostic tools. A transformer trained on 2,777,595 laboratory measurements from 3,905 patients with multiple myeloma or ovarian cancer predicted the two-year onset of 162 treatment-associated complications, including therapy-related myelodysplastic syndromes, spanning eight clinical categories, achieving 1.5- to 6.1-fold enrichment above prevalence at the group level. It matched or outperformed non-sequential baselines across grouped endpoints (AUROC gains up to +0.11), demonstrating that longitudinal laboratory trajectories capture evolving complication-specific physiology inaccessible from isolated measurements. Predictions generalised across both cancers, divergence concentrating in disease-specific complications, and biomarker masking recovered signatures consistent with established pathophysiology. External validation on MIMIC-IV and MMRF CoMMpass confirmed transferability across independent healthcare systems (AUROC up to 0.85). Routine oncological laboratory data encode organ deterioration weeks to months before clinical onset, enabling complication-specific surveillance without additional testing infrastructure.

医学预测时序建模癌症治疗多模态数据

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