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原发性醛固酮增多症中的人工智能:当前成果与未来挑战。

Artificial intelligence in primary aldosteronism: current achievements and future challenges.

作者信息

Xu Yisi, Liu Benjin, Huang Xuqi, Guo Xudong, Suo Ning, Jiang Shaobo, Wang Hanbo

机构信息

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.

出版信息

Front Mol Biosci. 2025 Aug 21;12:1660588. doi: 10.3389/fmolb.2025.1660588. eCollection 2025.

DOI:10.3389/fmolb.2025.1660588
PMID:40919575
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12409972/
Abstract

Recent advances in artificial intelligence (AI) are reshaping the diagnostic and therapeutic of primary aldosteronism (PA). For screening, machine learning models integrate multidimensional data to improve the efficiency of PA detection, facilitating large-scale population screening. For diagnosis, AI-driven algorithms have further enhanced the specificity of PA identification. In subtype classification, AI algorithms achieve high predictive accuracy in differentiating PA subtypes through comprehensive analysis of clinical, imaging, and biochemical data, while simultaneously reducing reliance on invasive diagnostic procedures. Regarding treatment decision-making and outcome, predictive models guide personalized therapy by assessing treatment responses and surgical results. These models also contribute to discovering potential drugs by analyzing molecular targets computationally. Although scientists have achieved notable progress, there remain substantial challenges in clinical implementation, including limited sample size, insufficient model interpretability, and a lack of real-world validation. To translate technical advances into clinical practice, the field requires more reliable AI models with clear decision-making processes and rigorous multicenter validation studies. Future research should focus on clinical practice by developing integrated diagnostic-treatment pathways, while leveraging AI's strengths and overcoming its current limitations in generalizability and clinical acceptance.​.

摘要

人工智能(AI)的最新进展正在重塑原发性醛固酮增多症(PA)的诊断和治疗。在筛查方面,机器学习模型整合多维数据以提高PA检测效率,便于大规模人群筛查。在诊断方面,人工智能驱动的算法进一步提高了PA识别的特异性。在亚型分类中,人工智能算法通过对临床、影像和生化数据的综合分析,在区分PA亚型方面实现了高预测准确性,同时减少了对侵入性诊断程序的依赖。在治疗决策和结果方面,预测模型通过评估治疗反应和手术结果来指导个性化治疗。这些模型还通过计算分析分子靶点来助力发现潜在药物。尽管科学家们已取得显著进展,但在临床应用中仍存在重大挑战,包括样本量有限、模型可解释性不足以及缺乏真实世界验证。为了将技术进步转化为临床实践,该领域需要更可靠的人工智能模型,其决策过程清晰且经过严格的多中心验证研究。未来的研究应通过开发综合诊断-治疗路径聚焦于临床实践,同时发挥人工智能的优势并克服其目前在可推广性和临床接受度方面的局限性。

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本文引用的文献

1
ATP2A3 in Primary Aldosteronism: Machine Learning-Based Discovery and Functional Validation.原发性醛固酮增多症中的ATP2A3:基于机器学习的发现与功能验证
Hypertension. 2025 Feb;82(2):319-332. doi: 10.1161/HYPERTENSIONAHA.124.23817. Epub 2024 Dec 2.
2
Circulating miRNAs and Machine Learning for Lateralizing Primary Aldosteronism.循环微小RNA与机器学习用于原发性醛固酮增多症的定位诊断
Hypertension. 2024 Dec;81(12):2479-2488. doi: 10.1161/HYPERTENSIONAHA.124.23418. Epub 2024 Oct 17.
3
Steroidomics-Based Screening for Primary Aldosteronism: Impact of antihypertensive Drugs.基于类固醇组学的原发性醛固酮增多症筛查:抗高血压药物的影响
Hypertension. 2024 Oct;81(10):2060-2071. doi: 10.1161/HYPERTENSIONAHA.124.23029. Epub 2024 Jul 31.
4
What We Know about and What Is New in Primary Aldosteronism.原发性醛固酮增多症的已知与新进展。
Int J Mol Sci. 2024 Jan 11;25(2):900. doi: 10.3390/ijms25020900.
5
Developing the novel diagnostic model and potential drugs by integrating bioinformatics and machine learning for aldosterone-producing adenomas.通过整合生物信息学和机器学习来开发用于醛固酮瘤的新型诊断模型和潜在药物。
Front Mol Biosci. 2024 Jan 4;10:1308754. doi: 10.3389/fmolb.2023.1308754. eCollection 2023.
6
Urine steroid metabolomics as a diagnostic tool in primary aldosteronism.尿类固醇代谢组学作为原发性醛固酮增多症的诊断工具。
J Steroid Biochem Mol Biol. 2024 Mar;237:106445. doi: 10.1016/j.jsbmb.2023.106445. Epub 2023 Dec 15.
7
Machine Learning Model with Computed Tomography Radiomics and Clinicobiochemical Characteristics Predict the Subtypes of Patients with Primary Aldosteronism.基于 CT 影像组学和临床生物化学特征的机器学习模型预测原发性醛固酮增多症患者的亚型。
Acad Radiol. 2024 May;31(5):1818-1827. doi: 10.1016/j.acra.2023.10.015. Epub 2023 Dec 1.
8
Artificial intelligence in clinical workflow processes in vascular surgery and beyond.人工智能在血管外科学及其他临床工作流程中的应用。
Semin Vasc Surg. 2023 Sep;36(3):401-412. doi: 10.1053/j.semvascsurg.2023.07.002. Epub 2023 Jul 22.
9
Key to the Treatment of Primary Aldosteronism in Secondary Hypertension: Subtype Diagnosis.继发性高血压中原发性醛固酮增多症治疗的关键:亚型诊断。
Curr Hypertens Rep. 2023 Dec;25(12):471-480. doi: 10.1007/s11906-023-01269-x. Epub 2023 Oct 3.
10
Integration of clinical parameters and CT-based radiomics improves machine learning assisted subtyping of primary hyperaldosteronism.临床参数与 CT 影像组学相结合可改善基于机器学习的原发性醛固酮增多症亚型分类。
Front Endocrinol (Lausanne). 2023 Aug 24;14:1244342. doi: 10.3389/fendo.2023.1244342. eCollection 2023.