Marsh J W, Dvorchik I, Iwatsuki S
Department of Surgery, University Health Center of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15213, USA.
J Hepatobiliary Pancreat Surg. 1998;5(1):24-8. doi: 10.1007/pl00009946.
We aimed to determine the most appropriate candidates for liver transplantation based on their survival outcomes. Two hundred and fourteen patients who were transplanted in the presence of hepatocellular carcinoma (HCC) were analyzed. Patient groups were selected as "good risk" candidates for transplantation by our previously developed artificial network model or by the classic pTNM pathological classification system. The survival of the model-selected candidate groups was then compared to the survival of the candidates chosen as "good risk" by the pTNM classification (i.e. , pTNM stages I + II and pTNM stages I + II + III). Suitability for transplantation was judged by long-term survival rates (i.e., 1-10 years post-transplant). By using the neural network prediction model and the subsequent subgroup case analysis, it was possible to generate those combinations of risk factors which predetermined patient survival through HCC recurrence. By applying the developed neural network model to the transplant candidate pool for patients with HCC, it was possible to select the maximum number of suitable candidates for transplantation while minimizing donor organ loss to recurrent HCC.
我们旨在根据生存结果确定肝移植的最合适候选人。对214例在肝细胞癌(HCC)存在的情况下接受移植的患者进行了分析。通过我们先前开发的人工网络模型或经典的pTNM病理分类系统,将患者组选为移植的“低风险”候选人。然后将模型选择的候选组的生存率与pTNM分类选为“低风险”的候选人(即pTNM I + II期和pTNM I + II + III期)的生存率进行比较。通过长期生存率(即移植后1至10年)来判断移植的适宜性。通过使用神经网络预测模型和随后的亚组病例分析,可以生成那些通过HCC复发预先确定患者生存的危险因素组合。通过将开发的神经网络模型应用于HCC患者的移植候选库,可以选择最大数量的合适移植候选人,同时将供体器官因复发性HCC而损失降至最低。