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基于监测、流行病学和最终结果分析的直肠腺癌患者生存预测的深度学习模型。

Deep-learning model for predicting the survival of rectal adenocarcinoma patients based on a surveillance, epidemiology, and end results analysis.

机构信息

Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.

出版信息

BMC Cancer. 2022 Feb 25;22(1):210. doi: 10.1186/s12885-022-09217-9.

Abstract

BACKGROUND

We collected information on patients with rectal adenocarcinoma in the United States from the Surveillance, Epidemiology, and EndResults (SEER) database. We used this information to establish a model that combined deep learning with a multilayer neural network (the DeepSurv model) for predicting the survival rate of patients with rectal adenocarcinoma.

METHODS

We collected patients with rectal adenocarcinoma in the United States and older than 20 yearswho had been added to the SEER database from 2004 to 2015. We divided these patients into training and test cohortsat a ratio of 7:3. The training cohort was used to develop a seven-layer neural network based on the analysis method established by Katzman and colleagues to construct a DeepSurv prediction model. We then used the C-index and calibration plots to evaluate the prediction performance of the DeepSurv model.

RESULTS

The 49,275 patients with rectal adenocarcinoma included in the study were randomly divided into the training cohort (70%, n = 34,492) and the test cohort (30%, n = 14,783). There were no statistically significant differences in clinical characteristics between the two cohorts (p > 0.05). We applied Cox proportional-hazards regression to the data in the training cohort, which showed that age, sex, marital status, tumor grade, surgery status, and chemotherapy status were significant factors influencing survival (p < 0.05). Using the training cohort to construct the DeepSurv model resulted in a C-index of the model of 0.824, while using the test cohort to verify the DeepSurv model yielded a C-index of 0.821. Thesevalues show that the prediction effect of the DeepSurv model for the test-cohort patients was highly consistent with the prediction resultsfor the training-cohort patients.

CONCLUSION

The DeepSurv prediction model of the seven-layer neural network that we have established can accurately predict the survival rateand time of rectal adenocarcinoma patients.

摘要

背景

我们从监测、流行病学和最终结果(SEER)数据库中收集了美国直肠腺癌患者的信息。我们利用这些信息建立了一个结合深度学习和多层神经网络(DeepSurv 模型)的模型,用于预测直肠腺癌患者的生存率。

方法

我们在美国收集了年龄大于 20 岁并在 2004 年至 2015 年期间被添加到 SEER 数据库中的直肠腺癌患者。我们将这些患者分为训练和测试队列,比例为 7:3。使用 Katzman 及其同事建立的分析方法,对训练队列进行分析,构建了一个七层神经网络,在此基础上构建了 DeepSurv 预测模型。然后使用 C 指数和校准图评估 DeepSurv 模型的预测性能。

结果

本研究纳入的 49275 例直肠腺癌患者被随机分为训练队列(70%,n=34492)和测试队列(30%,n=14783)。两组患者的临床特征无统计学差异(p>0.05)。我们对训练队列中的数据进行 Cox 比例风险回归分析,结果显示年龄、性别、婚姻状况、肿瘤分级、手术状态和化疗状态是影响生存的显著因素(p<0.05)。使用训练队列构建 DeepSurv 模型,模型的 C 指数为 0.824,使用测试队列验证 DeepSurv 模型,模型的 C 指数为 0.821。这些值表明,DeepSurv 模型对测试队列患者的预测效果与对训练队列患者的预测结果高度一致。

结论

我们建立的七层神经网络 DeepSurv 预测模型可以准确预测直肠腺癌患者的生存率和时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07bb/8881858/bffb0151bf63/12885_2022_9217_Fig1_HTML.jpg

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