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基于机器学习和传统方法评估早期乳腺癌患者的风险因素和生存率。

Evaluation of risk factors and survival rates of patients with early-stage breast cancer with machine learning and traditional methods.

机构信息

Marmara University, School of Medicine, Department of Biostatistics, Turkiye.

Department of Mathematics and Physics. School of Science and Technology. Nottingham Trent University. United Kingdom. Girne American University, Faculty of Medicine, Department of Biostatistics, Cyprus.

出版信息

Int J Med Inform. 2024 Oct;190:105548. doi: 10.1016/j.ijmedinf.2024.105548. Epub 2024 Jul 11.

Abstract

BACKGROUND

This article is aimed to make predictions in terms of prognostic factors and compare prediction methods by using Cox proportional hazards regression analysis (CPH), some machine learning techniques and Accelerated Failure Time (AFT) model for post-treatment survival probabilities according to clinical presentations and pathological information of early-stage breast cancer patients.

MATERIAL AND METHODS

The study was carried out in three stages. In the first stage, the CPH method was applied. In the second stage, the AFT model and in the last stage, machine learning methods were applied. The data set consists of 697 breast cancer patients who applied to Marmara University Hospital oncology clinic between 01.01.1994 and 31.12.2009. The models obtained by using various parameters of the patients were compared according to the C index, 5-year survival rate and 10-year survival rate.

RESULTS AND CONCLUSION

According to the models obtained as a result of the analyses applied, MetLN and age were obtained as a significant risk factor as a result of CPH method and AFT methods, while MetLN, age, tumor size, LV1 and extracapsular involvement were obtained as risk factors in machine learning methods. In addition, when the c-index values of the handheld models are examined, it is obtained as 69.8 for the CPH model, 70.36 for the AFT model, 72.1 for the random survival forest and 72.8 for the gradient boosting machine. In conclusion, the study highlights the potential of comparing conventional statistical methods and machine-learning algorithms to improve the precision of risk factor determination in early-stage breast cancer prognosis. Additionally, efforts should be made to enhance the interpretability of machine-learning models, ensuring that the results obtained can be effectively communicated and utilized by clinical practitioners. This would enable more informed decision-making and personalized care in the treatment and follow-up processes for early-stage breast cancer patients.

摘要

背景

本文旨在根据早期乳腺癌患者的临床表现和病理信息,通过 Cox 比例风险回归分析(CPH)、一些机器学习技术和加速失效时间(AFT)模型,对预后因素进行预测,并比较预测方法。

材料和方法

该研究分三个阶段进行。第一阶段应用 CPH 方法,第二阶段应用 AFT 模型,最后阶段应用机器学习方法。数据集包含了 1994 年 1 月 1 日至 2009 年 12 月 31 日期间在马尔马拉大学医院肿瘤诊所就诊的 697 名乳腺癌患者。根据 C 指数、5 年生存率和 10 年生存率,比较了使用患者不同参数获得的模型。

结果和结论

根据分析结果,CPH 方法和 AFT 方法得出 MetLN 和年龄是显著的风险因素,而机器学习方法得出 MetLN、年龄、肿瘤大小、LV1 和包膜外侵犯是风险因素。此外,当检查手持模型的 c 指数值时,CPH 模型为 69.8,AFT 模型为 70.36,随机生存森林为 72.1,梯度提升机为 72.8。总之,该研究强调了比较传统统计方法和机器学习算法的潜力,以提高早期乳腺癌预后中风险因素确定的准确性。此外,应该努力提高机器学习模型的可解释性,确保获得的结果可以由临床医生有效沟通和利用。这将使早期乳腺癌患者的治疗和随访过程能够做出更明智的决策和提供个性化的护理。

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