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基于随机森林算法构建肺癌化疗患者骨髓抑制辅助评分模型

Construction of an auxiliary scoring model for myelosuppression in patients with lung cancer chemotherapy based on random forest algorithm.

作者信息

Dong Yingjun, Hu Changqing, Liu Jun, Lv Huifang

机构信息

Intensive Care Unit, Shanxi Provincial Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University Taiyuan 030013, Shanxi, China.

Department of Cardiology, Shanxi Provincial People's Hospital Taiyuan 030012, Shanxi, China.

出版信息

Am J Transl Res. 2023 Jun 15;15(6):4155-4163. eCollection 2023.

Abstract

OBJECTIVE

To construct an auxiliary scoring model for myelosuppression in patients with lung cancer undergoing chemotherapy based on a random forest algorithm, and to evaluate the predictive performance of the model.

METHODS

Patients with lung cancer who received chemotherapy in Shanxi Province Cancer Hospital from January 2019 to January 2022 were retrospectively selected as research subjects, and their general demographic information, disease-related indicators, and laboratory test results before chemotherapy were collected. Patients were divided into a training set (136 cases) and a validation set (68 cases) in a ratio of 2:1. R software was used to establish a scoring model of myelosuppression in lung cancer patients in the training set, and the receiver operating characteristic curve, accuracy, sensitivity, and balanced F-score were used in the two data sets to evaluate the predictive performance of the model.

RESULTS

Among the 204 lung cancer patients enrolled, 75 patients developed myelosuppression during the follow-up period after chemotherapy, with an incidence of 36.76%. The factors in the constructed random forest model were ranked in order of age (23.233), bone metastasis (21.704), chemotherapy course (19.259), Alb (13.833), and gender (11.471) according to the mean decrease accuracy. The areas under the curve of the model in the training and validation sets were 0.878 and 0.885, respectively (all < 0.05). The predictive accuracy of the validated model was 82.35%, the sensitivity and specificity were 84.00% and 81.40%, respectively, and the balanced F-score was 77.78% (all < 0.05).

CONCLUSION

The risk assessment model for the occurrence of myelosuppression in patients with lung cancer chemotherapy based on a random forest algorithm can provide a reference for the accurate identification of high-risk patients.

摘要

目的

基于随机森林算法构建肺癌化疗患者骨髓抑制的辅助评分模型,并评估该模型的预测性能。

方法

回顾性选取2019年1月至2022年1月在山西省肿瘤医院接受化疗的肺癌患者作为研究对象,收集其一般人口学信息、疾病相关指标及化疗前实验室检查结果。患者按2∶1比例分为训练集(136例)和验证集(68例)。使用R软件在训练集中建立肺癌患者骨髓抑制的评分模型,并在两个数据集中采用受试者操作特征曲线、准确率、灵敏度和平衡F值来评估模型的预测性能。

结果

纳入的204例肺癌患者中,75例在化疗后随访期间发生骨髓抑制,发生率为36.76%。构建的随机森林模型中的因素按平均准确度下降排序依次为年龄(23.233)、骨转移(21.704)、化疗疗程(19.259)、白蛋白(13.833)和性别(11.47l)。模型在训练集和验证集的曲线下面积分别为0.878和0.885(均P<0.05)。验证模型的预测准确率为82.35%,灵敏度和特异度分别为84.00%和81.40%,平衡F值为77.78%(均P<0.05)。

结论

基于随机森林算法的肺癌化疗患者骨髓抑制发生风险评估模型可为准确识别高危患者提供参考。

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