Yan Si-Yan, Fu Xin-Yu, Tang Shen-Ping, Qi Rong-Bin, Liang Jia-Wei, Mao Xin-Li, Ye Li-Ping, Li Shao-Wei
Taizhou Hospital of Zhejiang Province, Zhejiang University, Hangzhou, Zhejiang, China.
Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang, China.
Digit Health. 2024 Sep 5;10:20552076241277713. doi: 10.1177/20552076241277713. eCollection 2024 Jan-Dec.
To optimize gastric cancer screening score and reduce screening costs using machine learning models.
This study included 228,634 patients from the Taizhou Gastric Cancer Screening Program. We used three machine learning models to optimize Li's gastric cancer screening score: Gradient Boosting Machine (GBM), Distributed Random Forest (DRF), and Deep Learning (DL). The performance of the binary classification models was evaluated using the area under the curve (AUC) and area under the precision-recall curve (AUCPR).
In the binary classification model used to distinguish low-risk and moderate- to high-risk patients, the AUC in the GBM, DRF, and DL full models were 0.9994, 0.9982, and 0.9974, respectively, and the AUCPR was 0.9982, 0.9949, and 0.9918, respectively. Excluding IgG antibody, pepsinogen I, and pepsinogen II, the AUC in the GBM, DRF, and DL models were 0.9932, 0.9879, and 0.9900, respectively, and the AUCPR was 0.9835, 0.9716, and 0.9752, respectively. Remodel after removing variables IgG, PGI, PGII, and G-17, the AUC in GBM, DRF, and DL was 0.8524, 0.8482, 0.8477, and AUCPR was 0.6068, 0.6008, and 0.5890, respectively. When constructing a tri-classification model, we discovered that none of the three machine learning models could effectively distinguish between patients at intermediate and high risk for gastric cancer (F1 scores in the GBM model for the low, medium and high risk: 0.9750, 0.9193, 0.5334, respectively; F1 scores in the DRF model for low, medium, and high risks: 0.9888, 0.9479, 0.6694, respectively; F1 scores in the DL model for low, medium, and high risks: 0.9812, 0.9216, 0.6394, respectively).
We concluded that gastric cancer screening indicators could be optimized when distinguishing low-risk and moderate to high-risk populations, and detecting gastrin-17 alone can achieve a good discriminative effect, thus saving huge expenditures.
使用机器学习模型优化胃癌筛查评分并降低筛查成本。
本研究纳入了来自泰州胃癌筛查项目的228,634名患者。我们使用三种机器学习模型来优化李式胃癌筛查评分:梯度提升机(GBM)、分布式随机森林(DRF)和深度学习(DL)。使用曲线下面积(AUC)和精确召回率曲线下面积(AUCPR)评估二分类模型的性能。
在用于区分低风险和中高风险患者的二分类模型中,GBM、DRF和DL全模型的AUC分别为0.9994、0.9982和0.9974,AUCPR分别为0.9982、0.9949和0.9918。排除IgG抗体、胃蛋白酶原I和胃蛋白酶原II后,GBM、DRF和DL模型的AUC分别为0.9932、0.9879和0.9900,AUCPR分别为0.9835、0.9716和0.9752。去除变量IgG、PGI、PGII和G-17后重新建模,GBM、DRF和DL的AUC分别为0.8524、0.8482、0.8477,AUCPR分别为0.6068、0.6008和0.5890。在构建三分类模型时,我们发现三种机器学习模型均无法有效区分胃癌中高风险患者(GBM模型中低、中、高风险的F1分数分别为:0.9750、0.9193、0.5334;DRF模型中低、中、高风险的F1分数分别为:0.9888、0.9479、0.6694;DL模型中低、中、高风险的F1分数分别为:0.9812、0.9216、0.6394)。
我们得出结论,在区分低风险和中高风险人群时,胃癌筛查指标可以优化,单独检测胃泌素-17可取得良好的判别效果,从而节省巨额开支。