Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Cheeloo College of Medicine, Shandong University, Jinan, China.
Thorac Cancer. 2021 Jun;12(12):1881-1889. doi: 10.1111/1759-7714.13991. Epub 2021 May 11.
Considering the high morbidity and mortality of lung cancer and the high incidence of pulmonary nodules, clearly distinguishing benign from malignant lung nodules at an early stage is of great significance. However, determining the kind of lung nodule which is more prone to lung cancer remains a problem worldwide.
A total of 480 patients with pulmonary nodule data were collected from Shandong, China. We assessed the clinical characteristics and computed tomography (CT) imaging features among pulmonary nodules in patients who had undergone video-assisted thoracoscopic surgery (VATS) lobectomy from 2013 to 2018. Preliminary selection of features was based on a statistical analysis using SPSS. We used WEKA to assess the machine learning models using its multiple algorithms and selected the best decision tree model using its optimization algorithm.
The combination of decision tree and logistics regression optimized the decision tree without affecting its AUC. The decision tree structure showed that lobulation was the most important feature, followed by spiculation, vessel convergence sign, nodule type, satellite nodule, nodule size and age of patient.
Our study shows that decision tree analyses can be applied to screen individuals for early lung cancer with CT. Our decision tree provides a new way to help clinicians establish a logical diagnosis by a stepwise progression method, but still needs to be validated for prospective trials in a larger patient population.
考虑到肺癌的高发病率和死亡率以及肺结节的高发生率,早期明确区分良性和恶性肺结节具有重要意义。然而,确定哪种肺结节更容易患肺癌仍然是一个全球性的问题。
本研究共收集了 2013 年至 2018 年在中国山东接受电视辅助胸腔镜手术(VATS)肺叶切除术的 480 例肺结节患者的数据。我们评估了这些患者的临床特征和 CT 成像特征。初步选择特征是基于使用 SPSS 进行的统计分析。我们使用 WEKA 评估了其多种算法的机器学习模型,并使用其优化算法选择了最佳决策树模型。
决策树和逻辑回归的组合优化了决策树,而不会影响其 AUC。决策树结构表明,分叶征是最重要的特征,其次是棘突征、血管汇聚征、结节类型、卫星结节、结节大小和患者年龄。
我们的研究表明,决策树分析可应用于 CT 筛查早期肺癌患者。我们的决策树提供了一种新的方法,可以帮助临床医生通过逐步递进的方法建立逻辑诊断,但仍需要在更大的患者群体中进行前瞻性试验验证。