Department of Radiology, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China, 322000, Yiwu, Zhejiang, China.
Cancer Center, Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Sci Rep. 2024 Sep 12;14(1):21285. doi: 10.1038/s41598-024-66952-8.
The occurrence of liver injury during cancer treatment is extremely harmful. The risk factors for drug.induced liver injury (DILI) in the pancreatic cancer population have not been investigated. This study aims to develop and validate an interpretable decision tree (DT) model for the early prediction of DILI in pancreatic cancer patients using multitemporal clinical data and screening for related risk factors. A retrospective collection of data was conducted on 307 patients, the training set (n = 215) was used to develop the model, and the test set (n = 92) was used to evaluate the model. The classification and regression trees algorithm was employed to establish the DT model. The Shapley Additive explanations (SHAP) method was used to facilitate clinical interpretation. Model performance was assessed using AUC and the Hosmer‒Lemeshow test. The DT model exhibited superior diagnostic efficacy, the AUC values were 0.995 and 0.994 in the training and test sets, respectively. Four risk factors associated with DILI occurrence were identified: delta.albumin, delta.ALT, and post (AST: ALT), and post.GGT. The multiperiod liver function indicator.based interpretable DT model predicted DILI occurrence in the pancreatic cancer population and contributes to personalized clinical management of pancreatic cancer patients.
在癌症治疗过程中发生肝损伤是极其有害的。尚未研究胰腺癌人群中药物性肝损伤 (DILI) 的危险因素。本研究旨在使用多时相临床数据和筛选相关危险因素,开发和验证一种可解释的决策树 (DT) 模型,用于早期预测胰腺癌患者的 DILI。回顾性收集了 307 名患者的数据,其中训练集 (n=215) 用于开发模型,测试集 (n=92) 用于评估模型。采用分类回归树算法建立 DT 模型。Shapley Additive explanations (SHAP) 方法用于促进临床解释。使用 AUC 和 Hosmer-Lemeshow 检验评估模型性能。DT 模型表现出优越的诊断效能,在训练集和测试集中的 AUC 值分别为 0.995 和 0.994。确定了与 DILI 发生相关的四个危险因素:delta.albumin、delta.ALT、post(AST:ALT)和 post.GGT。基于多期肝功能指标的可解释 DT 模型预测了胰腺癌人群中 DILI 的发生,有助于对胰腺癌患者进行个性化临床管理。