Li Y J, Wang Y, Qiu Z X
Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, State Key Laboratory of Respiratory Health and Multimorbidity, Chengdu 610041, China.
Department of Pulmonary and Critical Care Medicine/Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2024 Jun 12;47(6):566-570. doi: 10.3760/cma.j.cn112147-20231214-00370.
Lung cancer, which accounts for about 18% of all cancer-related deaths worldwide, has a dismal 5-year survival rate of less than 20%. Survival rates for early-stage lung cancers (stages IA1, IA2, IA3, and IB, according to the TNM staging system) are significantly higher, underscoring the critical importance of early detection, diagnosis, and treatment. Ground-glass nodules (GGNs), which are commonly seen on lung imaging, can be indicative of both benign and malignant lesions. For clinicians, accurately characterizing GGNs and choosing the right management strategies present significant challenges. Artificial intelligence (AI), specifically deep learning algorithms, has shown promise in the evaluation of GGNs by analyzing complex imaging data and predicting the nature of GGNs, including their benign or malignant status, pathological subtypes, and genetic mutations such as epidermal growth factor receptor (EGFR) mutations. By integrating imaging features and clinical data, AI models have demonstrated high accuracy in distinguishing between benign and malignant GGNs and in predicting specific pathological subtypes. In addition, AI has shown promise in predicting genetic mutations such as EGFR mutations, which are critical for personalized treatment decisions in lung cancer. While AI offers significant potential to improve the accuracy and efficiency of GGN assessment, challenges remain, such as the need for extensive validation studies, standardization of imaging protocols, and improving the interpretability of AI algorithms. In summary, AI has the potential to revolutionise the management of GGNs by providing clinicians with more accurate and timely information for diagnosis and treatment decisions. However, further research and validation are needed to fully realize the benefits of AI in clinical practice.
肺癌占全球所有癌症相关死亡人数的约18%,其5年生存率低至20%以下,令人沮丧。早期肺癌(根据TNM分期系统为IA1、IA2、IA3和IB期)的生存率显著更高,这突出了早期检测、诊断和治疗的至关重要性。肺磨玻璃结节(GGN)在肺部影像学检查中常见,可提示良性和恶性病变。对于临床医生而言,准确鉴别GGN并选择正确的管理策略面临重大挑战。人工智能(AI),特别是深度学习算法,通过分析复杂的影像数据并预测GGN的性质,包括其良性或恶性状态、病理亚型以及基因突变(如表皮生长因子受体(EGFR)突变),在GGN评估中显示出了前景。通过整合影像特征和临床数据,AI模型在区分良性和恶性GGN以及预测特定病理亚型方面已证明具有高准确性。此外,AI在预测EGFR突变等基因突变方面也显示出前景,这些突变对于肺癌的个性化治疗决策至关重要。虽然AI在提高GGN评估的准确性和效率方面具有巨大潜力,但挑战依然存在,例如需要进行广泛的验证研究、影像检查方案的标准化以及提高AI算法的可解释性。总之,AI有潜力通过为临床医生提供更准确、及时的诊断和治疗决策信息,彻底改变GGN的管理方式。然而,需要进一步的研究和验证,以充分实现AI在临床实践中的益处。