Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Suzhou, China.
Department of General Surgery, Changshu Hospital Affiliated to Soochow University, Suzhou, China.
Sci Rep. 2024 May 30;14(1):12415. doi: 10.1038/s41598-024-62311-9.
Gastrointestinal stromal tumors (GISTs) are a rare type of tumor that can develop liver metastasis (LIM), significantly impacting the patient's prognosis. This study aimed to predict LIM in GIST patients by constructing machine learning (ML) algorithms to assist clinicians in the decision-making process for treatment. Retrospective analysis was performed using the Surveillance, Epidemiology, and End Results (SEER) database, and cases from 2010 to 2015 were assigned to the developing sets, while cases from 2016 to 2017 were assigned to the testing set. Missing values were addressed using the multiple imputation technique. Four algorithms were utilized to construct the models, comprising traditional logistic regression (LR) and automated machine learning (AutoML) analysis such as gradient boost machine (GBM), deep neural net (DL), and generalized linear model (GLM). We evaluated the models' performance using LR-based metrics, including the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA), as well as AutoML-based metrics, such as feature importance, SHapley Additive exPlanation (SHAP) Plots, and Local Interpretable Model Agnostic Explanation (LIME). A total of 6207 patients were included in this study, with 2683, 1780, and 1744 patients allocated to the training, validation, and test sets, respectively. Among the different models evaluated, the GBM model demonstrated the highest performance in the training, validation, and test cohorts, with respective AUC values of 0.805, 0.780, and 0.795. Furthermore, the GBM model outperformed other AutoML models in terms of accuracy, achieving 0.747, 0.700, and 0.706 in the training, validation, and test cohorts, respectively. Additionally, the study revealed that tumor size and tumor location were the most significant predictors influencing the AutoML model's ability to accurately predict LIM. The AutoML model utilizing the GBM algorithm for GIST patients can effectively predict the risk of LIM and provide clinicians with a reference for developing individualized treatment plans.
胃肠道间质瘤(GIST)是一种罕见的肿瘤,可能发生肝转移(LIM),显著影响患者的预后。本研究旨在通过构建机器学习(ML)算法来预测 GIST 患者的 LIM,以协助临床医生进行治疗决策。使用监测、流行病学和最终结果(SEER)数据库进行回顾性分析,将 2010 年至 2015 年的病例分配到发展组,将 2016 年至 2017 年的病例分配到测试组。使用多重插补技术处理缺失值。使用四种算法构建模型,包括传统的逻辑回归(LR)和自动化机器学习(AutoML)分析,如梯度提升机(GBM)、深度神经网络(DL)和广义线性模型(GLM)。我们使用基于 LR 的指标评估模型的性能,包括接收者操作特征曲线(ROC)下的面积(AUC)、校准曲线和决策曲线分析(DCA),以及基于 AutoML 的指标,如特征重要性、Shapley 加性解释(SHAP)图和局部可解释模型不可知解释(LIME)。共有 6207 例患者纳入本研究,其中 2683、1780 和 1744 例患者分别分配到训练组、验证组和测试组。在评估的不同模型中,GBM 模型在训练、验证和测试队列中表现出最高的性能,AUC 值分别为 0.805、0.780 和 0.795。此外,GBM 模型在准确性方面优于其他 AutoML 模型,在训练、验证和测试队列中分别达到 0.747、0.700 和 0.706。此外,研究表明肿瘤大小和肿瘤位置是影响 AutoML 模型准确预测 LIM 能力的最重要预测因子。对于 GIST 患者,使用 GBM 算法的 AutoML 模型可以有效地预测 LIM 的风险,并为临床医生制定个体化治疗计划提供参考。