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用于预测宫颈癌患者生存率的混合机器学习方法的开发与验证:一项基于监测、流行病学和最终结果(SEER)的人群研究

Development and validation of hybrid machine learning approach for predicting survival in patients with cervical cancer: a SEER-based population study.

作者信息

Kolasseri Anjana Eledath, B Venkataramana

机构信息

School of Advanced Sciences, Vellore Institute of Technology, Vellore Tamil Nadu, India.

出版信息

Front Oncol. 2025 Jun 18;15:1605378. doi: 10.3389/fonc.2025.1605378. eCollection 2025.

Abstract

BACKGROUND

Accurate survival prediction in cervical cancer is crucial for personalized therapy, particularly in high-risk groups where early intervention might enhance results. The study aims to create a hybrid survival model that integrates Cox Proportional Hazards (CoxPH) with Elastic Net regularization and Random Survival Forest (RSF) to improve prediction accuracy and interpretability.

METHODS

Data from the SEER database (2013-2015) were pre-processed through normalization and encoding. RSF recorded non-linear interactions between covariates, while the CoxPH Elastic Net Regularization model provided linear interpretability and identified key variables. Model parameters were optimized using cross-validation, and final performance was assessed on an independent test set using metrics including C-index, Integrated Brier Score (IBS), AUC-ROC, and calibration plots.

RESULTS

The hybrid model outperformed the individual models with an Integrated Brier Score (IBS) of 0.13 and a concordance index (C-index) of 0.82. With an AUC-ROC of 0.84, the model provided robust calibration and classification performance on the independent test set, effectively separating between individuals at high and low risk.

CONCLUSION

The hybrid model provides a promising tool for personalized risk stratification in cervical cancer based on survival probability. Further testing in varied clinical categories is recommended to confirm its efficiency in precision oncology.

摘要

背景

宫颈癌的准确生存预测对于个性化治疗至关重要,尤其是在早期干预可能改善结果的高危人群中。本研究旨在创建一种混合生存模型,该模型将Cox比例风险模型(CoxPH)与弹性网络正则化和随机生存森林(RSF)相结合,以提高预测准确性和可解释性。

方法

对来自SEER数据库(2013 - 2015年)的数据进行归一化和编码预处理。随机生存森林记录协变量之间的非线性相互作用,而CoxPH弹性网络正则化模型提供线性可解释性并识别关键变量。使用交叉验证优化模型参数,并使用包括C指数、综合Brier评分(IBS)、AUC - ROC和校准图在内的指标在独立测试集上评估最终性能。

结果

混合模型优于单个模型,综合Brier评分为0.13,一致性指数(C指数)为0.82。该模型的AUC - ROC为0.84,在独立测试集上提供了稳健的校准和分类性能,有效区分了高风险和低风险个体。

结论

该混合模型为基于生存概率的宫颈癌个性化风险分层提供了一种有前景的工具。建议在不同临床类别中进一步测试,以确认其在精准肿瘤学中的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c644/12213391/43dac7c14f1a/fonc-15-1605378-g001.jpg

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