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Preoperative prediction of intrahepatic cholangiocarcinoma lymph node metastasis by means of machine learning: a multicenter study in China

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机构: [1]Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospitalof Fujian Medical University, Xihong Road 312, Fuzhou, Fujian 350025, PR,China [2]Department of Radiology, Mengchao Hepatobiliary Hospital of FujianMedical University, Fuzhou, China [3]Department of Hepatobiliary, Heze MunicipleHospital, Heze, China [4]The Third Department of Hepatic Surgery, EasternHepatobiliary Surgery Hospital, Second Military Medical University, Shanghai,China [5]Department of General Surgery, Institute of Hepatobiliary-Pancreatic-Intestinal Diseases, Affiliated Hospital of North Sichuan Medical College,Nanchong, China [6]Department of Hepatobiliary and Pancreatic Surgery,The Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou, China
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关键词: Intrahepatic cholangiocarcinoma Lymph node metastasis Machine learning

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Background Hepatectomy is currently the most effective modality for the treatment of intrahepatic cholangiocarcinoma (ICC). The status of the lymph nodes directly affects the choice of surgical method and the formulation of postoperative treatment plans. Therefore, a preoperative judgment of lymph node status is of great significance for patients diagnosed with this condition. Previous prediction models mostly adopted logistic regression modeling, and few relevant studies applied random forests in the prediction of ICC lymph node metastasis (LNM). Methods A total of 149 ICC patients who met clinical conditions were enrolled in the training group. Taking into account preoperative clinical data and imaging features, 21 indicators were included for analysis and modeling. Logistic regression was used to filter variables through multivariate analysis, and random forest regression was used to rank the importance of these variables through the use of algorithms. The model's prediction accuracy was assessed by the concordance index (C-index) and calibration curve and validated with external data. Result Multivariate analysis shows that Carcinoembryonic antigen (CEA), Carbohydrate antigen19-9 (CA19-9), and lymphadenopathy on imaging are independent risk factors for lymph node metastasis. The random forest algorithm identifies the top four risk factors as CEA, CA19-9, and lymphadenopathy on imaging and Aspartate Transaminase (AST). The predictive power of random forest is significantly better than the nomogram established by logistic regression in both the validation group and the training group (Area Under Curve reached 0.758 in the validation group). Conclusions We constructed a random forest model for predicting lymph node metastasis that, compared with the traditional nomogram, has higher prediction accuracy and simultaneously plays an auxiliary role in imaging examinations.

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出版当年[2022]版:
大类 | 2 区 医学
小类 | 3 区 肿瘤学
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大类 | 2 区 医学
小类 | 3 区 肿瘤学
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Q2 ONCOLOGY
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Q2 ONCOLOGY

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第一作者机构: [1]Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospitalof Fujian Medical University, Xihong Road 312, Fuzhou, Fujian 350025, PR,China
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