Shen Ziyuan, Zhang Shuo, Jiao Yaxue, Shi Yuye, Zhang Hao, Wang Fei, Wang Ling, Zhu Taigang, Miao Yuqing, Sang Wei, Cai Guoqi, Huaihai Lymphoma Working Group
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China.
Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, China.
J Oncol. 2022 Sep 16;2022:1618272. doi: 10.1155/2022/1618272. eCollection 2022.
BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous non-Hodgkin's lymphoma with great clinical challenge. Machine learning (ML) has attracted substantial attention in diagnosis, prognosis, and treatment of diseases. This study is aimed at exploring the prognostic factors of DLBCL by ML. METHODS: In total, 1211 DLBCL patients were retrieved from Huaihai Lymphoma Working Group (HHLWG). The least absolute shrinkage and selection operator (LASSO) and random forest algorithm were used to identify prognostic factors for the overall survival (OS) rate of DLBCL among twenty-five variables. Receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were utilized to compare the predictive performance and clinical effectiveness of the two models, respectively. RESULTS: The median follow-up time was 43.4 months, and the 5-year OS was 58.5%. The LASSO model achieved an Area under the curve (AUC) of 75.8% for the prognosis of DLBCL, which was higher than that of the random forest model (AUC: 71.6%). DCA analysis also revealed that the LASSO model could augment net benefits and exhibited a wider range of threshold probabilities by risk stratification than the random forest model. In addition, multivariable analysis demonstrated that age, white blood cell count, hemoglobin, central nervous system involvement, gender, and Ann Arbor stage were independent prognostic factors for DLBCL. The LASSO model showed better discrimination of outcomes compared with the IPI and NCCN-IPI models and identified three groups of patients: low risk, high-intermediate risk, and high risk. CONCLUSIONS: The prognostic model of DLBCL based on the LASSO regression was more accurate than the random forest, IPI, and NCCN-IPI models.
背景:弥漫性大B细胞淋巴瘤(DLBCL)是一种异质性非霍奇金淋巴瘤,具有重大临床挑战。机器学习(ML)在疾病的诊断、预后和治疗方面已引起广泛关注。本研究旨在通过机器学习探索DLBCL的预后因素。 方法:从淮海淋巴瘤工作组(HHLWG)检索了总共1211例DLBCL患者。采用最小绝对收缩和选择算子(LASSO)及随机森林算法,在25个变量中识别DLBCL总生存率(OS)的预后因素。分别利用受试者工作特征(ROC)曲线和决策曲线分析(DCA)比较两种模型的预测性能和临床有效性。 结果:中位随访时间为43.4个月,5年总生存率为58.5%。LASSO模型对DLBCL预后的曲线下面积(AUC)为75.8%,高于随机森林模型(AUC:71.6%)。DCA分析还显示,LASSO模型可增加净效益,且与随机森林模型相比,通过风险分层显示出更广泛的阈值概率范围。此外,多变量分析表明,年龄、白细胞计数、血红蛋白、中枢神经系统受累、性别和Ann Arbor分期是DLBCL的独立预后因素。与国际预后指数(IPI)和美国国立综合癌症网络(NCCN)-IPI模型相比,LASSO模型对预后的区分度更好,并识别出三组患者:低风险、高中间风险和高风险。 结论:基于LASSO回归的DLBCL预后模型比随机森林、IPI和NCCN-IPI模型更准确。
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