Hu R, Zhong Q, Xu Z G, Huang L Y, Cheng Y, Wang Y R, He Y D, Cheng Yingduan
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China.
Department of Urology, the First Affiliated Hospital of Southern University of Science and Technology, the Second Clinical Medical College of Jinan University, Shenzhen People's Hospital,Shenzhen 518000, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 May 7;56(5):454-458. doi: 10.3760/cma.j.cn115330-20200927-00773.
To explore the possibility of using artificial intelligence (AI) technology based on convolutional neural network (CNN) to assist the clinical diagnosis of laryngeal squamous cell carcinoma (LSCC) through deep learning algorithm. A deep CNN was developed and applied in narrow band imaging (NBI) endoscopy of 4 799 patients with laryngeal lesions, including 3 168 males and 1 631 females, aged from 21 to 87 years, from 2015 to 2017 in Beijing Tongren Hospital, Capital Medical University. A simple randomization method was used to select the laryngeal NBI images of 2 427 patients (1 388 benign lesions and 1 039 LSCC lesions) for the training and correction the CNN model. The remaining laryngeal NBI images of 2 372 patients (including 1 276 benign lesions and 1 096 LSCC lesions) were used as validation data set to compare performance between CNN and otolaryngologists. SPSS 21.0 software was used for Chi-square test to calculate the accuracy, sensitivity and specificity of AI and otolaryngologists. The area under the curve (AUC) of receiver operating curve (ROC) was used to evaluate the diagnostic ability of the algorithm for NBI images. The accuracy, sensitivity and specificity for NBI predictions were respectively 90.91% (AUC=0.96), 90.12% and 91.53%, which were equivalent to those for otolaryngologists' predictions (accuracy, sensitivity and specificity were (91.93±3.20)%, (91.33±3.25)% and (93.02±2.59)% values were 0.64, 0.75 and 1.17, and values were 0.32, 0.28 and 0.21, respectively). The diagnostic efficiency of CNN was significantly higher than that of otolaryngologists (0.01 5.50, =9.15, <0.001). AI based on deep CNN is effective for using in the laryngeal NBI image diagnosis, showing a good application prospect in the diagnosis of LSCC.
为探讨基于卷积神经网络(CNN)的人工智能(AI)技术通过深度学习算法辅助喉鳞状细胞癌(LSCC)临床诊断的可能性。开发了一种深度CNN并将其应用于首都医科大学附属北京同仁医院2015年至2017年收治的4799例喉部病变患者的窄带成像(NBI)内镜检查,其中男性3168例,女性1631例,年龄21至87岁。采用简单随机化方法选取2427例患者(1388例良性病变和1039例LSCC病变)的喉部NBI图像用于训练和校正CNN模型。将其余2372例患者(包括1276例良性病变和1096例LSCC病变)的喉部NBI图像作为验证数据集,比较CNN与耳鼻喉科医生的诊断性能。使用SPSS 21.0软件进行卡方检验,计算AI和耳鼻喉科医生的准确性、敏感性和特异性。采用受试者操作特征曲线(ROC)下的面积(AUC)评估算法对NBI图像的诊断能力。NBI预测的准确性、敏感性和特异性分别为90.91%(AUC = 0.96)、90.12%和91.53%,与耳鼻喉科医生的预测结果相当(准确性、敏感性和特异性分别为(91.93±3.20)%、(91.33±3.25)%和(93.02±2.59)%),P值分别为0.64、0.75和1.17,以及P值分别为0.32、0.28和0.21)。CNN的诊断效率显著高于耳鼻喉科医生(P < 0.001)。基于深度CNN的AI在喉部NBI图像诊断中有效,在LSCC诊断中显示出良好的应用前景。