Zhao Chenxu, Sun Zhiming, Yu Yang, Lou Yiwei, Liu Liyuan, Li Ge, Liu Jumei, Chen Lei, Zhu Sainan, Huang Yu, Zhang Yang, Gao Ying
Department of Endocrinology, Peking University First Hospital, 100034, Beijing, China.
School of Computer Science, Peking University, 100871, Beijing, China.
Endocrine. 2024 Nov;86(2):672-681. doi: 10.1007/s12020-024-03889-y. Epub 2024 May 29.
This study aims to develop a non-invasive diagnosis model using machine learning (ML) for identifying high-risk IgG4 Hashimoto's thyroiditis (HT) patients.
A retrospective cohort of 93 HT patients and a prospective cohort of 179 HT patients were collected. According to the immunohistochemical and pathological results, the patients were divided into IgG4 HT group and non-IgG4 HT group. Serum TgAb IgG4 and TPOAb IgG4 were detected by ELISAs. A logistic regression model, support vector machine (SVM) and random forest (RF) were used to establish a clinical diagnosis model for IgG4 HT.
Among these 272 patients, 40 (14.7%) were diagnosed with IgG4 HT. Patients with IgG4 HT were younger than those with non-IgG4 HT (P < 0.05). Serum levels of TgAb IgG4 and TPOAb IgG4 in IgG4 HT group were significantly higher than those in non-IgG4 HT group (P < 0.05). There were no significant differences in gender, disease duration, goiter, preoperative thyroid function status, preoperative TgAb or TPOAb levels, and thyroid ultrasound characteristics between the two groups (all P > 0.05). The accuracy, sensitivity, and specificity were 57%, 78%, and 79% for logistic regression model of IgG4 HT, 80 ± 7%, 84.7% ± 2.6%, and 75.4% ± 9.6% for the RF model and 78 ± 5%, 89.8% ± 5.7%, and 64.7% ± 5.7% for the SVM model. The RF model works better than SVM. The area under the ROC curve of RF ranged 0.87 to 0.92.
A clinical diagnosis model for IgG4 HT established by RF model might help the early recognition of the high-risk patients of IgG4 HT.
本研究旨在开发一种使用机器学习(ML)的非侵入性诊断模型,用于识别高危IgG4桥本甲状腺炎(HT)患者。
收集了93例HT患者的回顾性队列和179例HT患者的前瞻性队列。根据免疫组化和病理结果,将患者分为IgG4 HT组和非IgG4 HT组。通过酶联免疫吸附测定法检测血清TgAb IgG4和TPOAb IgG4。使用逻辑回归模型、支持向量机(SVM)和随机森林(RF)建立IgG4 HT的临床诊断模型。
在这272例患者中,40例(14.7%)被诊断为IgG4 HT。IgG4 HT患者比非IgG4 HT患者年轻(P < 0.05)。IgG4 HT组的血清TgAb IgG4和TPOAb IgG4水平显著高于非IgG4 HT组(P < 0.05)。两组在性别、病程、甲状腺肿、术前甲状腺功能状态、术前TgAb或TPOAb水平以及甲状腺超声特征方面无显著差异(所有P > 0.05)。IgG4 HT逻辑回归模型的准确率、敏感性和特异性分别为57%、78%和79%,RF模型分别为80±7%、84.7%±2.6%和75.4%±9.6%,SVM模型分别为78±5%、89.8%±5.7%和64.7%±5.7%。RF模型比SVM模型表现更好。RF的ROC曲线下面积在0.87至0.92之间。
由RF模型建立的IgG4 HT临床诊断模型可能有助于早期识别IgG4 HT高危患者。