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人工智能辅助肺癌患者预后及药物疗效预测的决策:一项叙述性综述

Artificial intelligence-assisted decision making for prognosis and drug efficacy prediction in lung cancer patients: a narrative review.

作者信息

Li Jingwei, Wu Jiayang, Zhao Zhehao, Zhang Qiran, Shao Jun, Wang Chengdi, Qiu Zhixin, Li Weimin

机构信息

Department of Respiratory and Critical Care Medicine, West China Medical School/West China Hospital, Sichuan University, Chengdu, China.

West China Medical School/West China Hospital, Sichuan University, Chengdu, China.

出版信息

J Thorac Dis. 2021 Dec;13(12):7021-7033. doi: 10.21037/jtd-21-864.

Abstract

OBJECTIVE

In this review, we aim to present frontier studies in patients with lung cancer as it related to artificial intelligence (AI)-assisted decision-making and summarize the latest advances, challenges and future trend in this field.

BACKGROUND

Despite increasing survival rate in cancer patients over the last decades, lung cancer remains one of the leading causes of death worldwide. The early diagnosis, accurate evaluation and individualized treatment are vital approaches to improve the survival rate of patients with lung cancer. Thus, decision making based on these approaches requires accuracy and efficiency beyond manpower. Recent advances in AI and precision medicine have provided a fertile environment for the development of AI-based models. These models have the potential to assist radiologists and oncologists in detecting lung cancer, predicting prognosis and developing personalized treatment plans for better outcomes of the patients.

METHODS

We searched literature from 2000 through July 31, 2021 in Medline/PubMed, the Web of Science, the Cochrane Library, ACM Digital Library, INSPEC and EMBASE. Key words such as "artificial intelligence", "AI", "deep learning", "lung cancer", "NSCLC", "SCLC" were combined to identify related literatures. These literatures were then selected by two independent authors. Articles chosen by only one author will be examined by another author to determine whether this article was relative and valuable. The selected literatures were read by all authors and discussed to draw reliable conclusions.

CONCLUSIONS

AI, especially for those based on deep learning and radiomics, is capable of assisting clinical decision making from many aspects, for its quantitatively interpretation of patients' information and its potential to deal with the dynamics, individual differences and heterogeneity of lung cancer. Hopefully, remaining problems such as insufficient data and poor interpretability may be solved to put AI-based models into clinical practice.

摘要

目的

在本综述中,我们旨在介绍与人工智能(AI)辅助决策相关的肺癌患者前沿研究,并总结该领域的最新进展、挑战和未来趋势。

背景

尽管在过去几十年中癌症患者的生存率有所提高,但肺癌仍然是全球主要死因之一。早期诊断、准确评估和个体化治疗是提高肺癌患者生存率的关键途径。因此,基于这些途径的决策需要超越人力的准确性和效率。AI和精准医学的最新进展为基于AI的模型开发提供了肥沃的环境。这些模型有潜力协助放射科医生和肿瘤内科医生检测肺癌、预测预后并制定个性化治疗方案,以改善患者的治疗效果。

方法

我们检索了2000年至2021年7月31日期间Medline/PubMed、科学引文索引、考克兰图书馆、美国计算机协会数字图书馆、电气与电子工程师协会数据库和荷兰医学文摘数据库中的文献。将“人工智能”“AI”“深度学习”“肺癌”“非小细胞肺癌”“小细胞肺癌”等关键词组合起来以识别相关文献。然后由两位独立作者筛选这些文献。仅由一位作者选择的文章将由另一位作者进行审查,以确定该文章是否相关且有价值。所有作者阅读并讨论所选文献,以得出可靠的结论。

结论

AI,尤其是基于深度学习和放射组学的AI,能够从多个方面协助临床决策,因为它能够对患者信息进行定量解读,并具有处理肺癌的动态性、个体差异和异质性的潜力。有望解决诸如数据不足和可解释性差等遗留问题,以便将基于AI的模型应用于临床实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8218/8743400/e56b67975246/jtd-13-12-7021-f1.jpg

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