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Li Y, Chen L, Lv J, Chen X, Zeng B, Chen M, Guo W, Lin Y, Yu L, Hou J, Li J, Zhou P, Zhang W, Li S, Jin X, Cai W, Zhang K, Huang Y, Wang C, Fu F. Clinical application of artificial neural network (ANN) modeling to predict BRCA1/2 germline deleterious variants in Chinese bilateral primary breast cancer patients. BMC Cancer 2022; 22:1125. [PMID: 36324133 PMCID: PMC9628090 DOI: 10.1186/s12885-022-10160-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/19/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Bilateral breast cancer (BBC), as well as ovarian cancer, are significantly associated with germline deleterious variants in BRCA1/2, while BRCA1/2 germline deleterious variants carriers can exquisitely benefit from poly (ADP-ribose) polymerase (PARP) inhibitors. However, formal genetic testing could not be carried out for all patients due to extensive use of healthcare resources, which in turn results in high medical costs. To date, existing BRCA1/2 deleterious variants prediction models have been developed in women of European or other descent who are quite genetically different from Asian population. Therefore, there is an urgent clinical need for tools to predict the frequency of BRCA1/2 deleterious variants in Asian BBC patients balancing the increased demand for and cost of cancer genetics services. METHODS The entire coding region of BRCA1/2 was screened for the presence of germline deleterious variants by the next generation sequencing in 123 Chinese BBC patients. Chi-square test, univariate and multivariate logistic regression were used to assess the relationship between BRCA1/2 germline deleterious variants and clinicopathological characteristics. The R software was utilized to develop artificial neural network (ANN) and nomogram modeling for BRCA1/2 germline deleterious variants prediction. RESULTS Among 123 BBC patients, we identified a total of 20 deleterious variants in BRCA1 (8; 6.5%) and BRCA2 (12; 9.8%). c.5485del in BRCA1 is novel frameshift deleterious variant. Deleterious variants carriers were younger at first diagnosis (P = 0.0003), with longer interval between two tumors (P = 0.015), at least one medullary carcinoma (P = 0.001), and more likely to be hormone receptor negative (P = 0.006) and HER2 negative (P = 0.001). Area under the receiver operating characteristic curve was 0.903 in ANN and 0.828 in nomogram modeling individually (P = 0.02). CONCLUSION This study shows the spectrum of the BRCA1/2 germline deleterious variants in Chinese BBC patients and indicates that the ANN can accurately predict BRCA deleterious variants than conventional statistical linear approach, which confirms the BRCA1/2 deleterious variants carriers at the lowest costs without adding any additional examinations.
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Affiliation(s)
- Yan Li
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Lili Chen
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Jinxing Lv
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China ,grid.54549.390000 0004 0369 4060Sichuan Cancer Center, School of Medicine, Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, 610000 Chengdu, China
| | - Xiaobin Chen
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Bangwei Zeng
- grid.411176.40000 0004 1758 0478Nosocomial Infection Control Branch, Fujian Medical University Union Hospital, Fuzhou, Fujian Province China
| | - Minyan Chen
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Wenhui Guo
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Yuxiang Lin
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Liuwen Yu
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Jialin Hou
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Jing Li
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Peng Zhou
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Wenzhe Zhang
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Shengmei Li
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Xuan Jin
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Weifeng Cai
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Kun Zhang
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Yeyuan Huang
- grid.256112.30000 0004 1797 9307Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Chuan Wang
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
| | - Fangmeng Fu
- grid.411176.40000 0004 1758 0478Department of Breast Surgery, Fujian Medical University Union Hospital, No.29, Xin Quan Road, Gulou District, 350001 Fuzhou, Fujian Province China ,grid.411176.40000 0004 1758 0478Department of General Surgery, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian Province China ,grid.256112.30000 0004 1797 9307Breast Cancer Institute, Fujian Medical University, 350001 Fuzhou, Fujian Province China
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Zhu Y, Williams S, Zwiggelaar R. Computer technology in detection and staging of prostate carcinoma: A review. Med Image Anal 2006; 10:178-99. [PMID: 16150630 DOI: 10.1016/j.media.2005.06.003] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2004] [Revised: 02/02/2005] [Accepted: 06/22/2005] [Indexed: 11/20/2022]
Abstract
After two decades of increasing interest and research activity, computer-assisted diagnostic approaches are reaching the stage where more routine deployment in clinical practice is becoming a possibility [Kruppinski, E.A., 2004. Computer-aided detection in clinical environment: Benefits and challenges for radiologists. Radiology 231, 7-9]. This is particularly the case in the analysis of mammographic images [Helvie, M.A., Hadjiiski, L., Makariou, E., Chan, H.P., Petrick, N., Sahiner, B., Lo, S.C., Freedman, M., Adler, D., Bailey, J., Blane, C., Hoff, D., Hunt, K., Joynt, L., Klein, K., Paramagul, C., Patterson, S.K., Roubidoux, M.A., 2004. Sensitivity of noncommercial computer-aided detection system for mammographic breast cancer detection: pilot clinical trial. Radiology 231, 208-214] and in the detection of pulmonary nodules [Reeves, A.P., Kostis, W.J., 2000. Computer-aided diagnosis for lung cancer. Radiol. Clin. North Am. 38, 497-509]. However, similar approaches can be applied more widely with the promise of increasing clinical utility in other areas. We review how computer-aided approaches may be applied in the diagnosis and staging of prostatic cancer. The current status of computer technology is reviewed, covering artificial neural networks for detection and staging, computerised biopsy simulation and computer-assisted analysis of ultrasound and magnetic resonance images.
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Affiliation(s)
- Yanong Zhu
- School of Computing Sciences, University of East Anglia, Norwich, Norfolk NR4 7TJ, UK
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Stephan C, Cammann H, Semjonow A, Diamandis EP, Wymenga LFA, Lein M, Sinha P, Loening SA, Jung K. Multicenter Evaluation of an Artificial Neural Network to Increase the Prostate Cancer Detection Rate and Reduce Unnecessary Biopsies. Clin Chem 2002. [DOI: 10.1093/clinchem/48.8.1279] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background: The percentage of free prostate-specific antigen (%fPSA) has been shown to improve specificity for the diagnosis of prostate cancer (PCa) over total PSA (tPSA). A multicenter study was performed to evaluate the diagnostic value of a %fPSA-based artificial neural network (ANN) in men with tPSA concentrations between 2 and 20 μg/L for detecting patients with increased risk of a positive prostate biopsy for cancer.
Methods: We enrolled 1188 men from six different hospitals with PCa or benign prostates between 1996 and 2001. We used a newly developed ANN with input data of tPSA, %fPSA, patient age, prostate volume, and digital rectal examination (DRE) status to calculate the risk for the presence of PCa within different tPSA ranges (2–4, 4.1–10, 2–10, 10.1–20, and 2–20 μg/L) at the 90% and 95% specificity or sensitivity cutoffs, depending on the tPSA concentration. ROC analysis and cutoff calculations were used to estimate the diagnostic improvement of the ANN compared with %fPSA alone.
Results: In the low tPSA range (2–4 μg/L), the ANN detected 72% and 65% of cancers at specificities of 90% or 95%, respectively. At 4–10 μg/L tPSA, the ANN detected 90% and 95% of cancers with specificities of 62% and 41%, respectively. Use of the ANN with 2–10 μg/L tPSA enhanced the specificity of %fPSA by 20–22%, thus reducing the number of unnecessary biopsies.
Conclusions: Enhanced accuracy of PCa detection over that obtained using %fPSA alone can be achieved with a %fPSA-based ANN that also includes clinical information from DRE and prostate volume measurements.
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Affiliation(s)
- Carsten Stephan
- Departments of Urology and
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, M5G 1X5 Canada
| | - Henning Cammann
- Institute for Medical Biometry, University Hospital Charité, Humboldt University, D-10098 Berlin, Germany
| | - Axel Semjonow
- Department of Urology, Westfälische Wilhelms-University, D-48129 Münster, Germany
| | - Eleftherios P Diamandis
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, M5G 1X5 Canada
| | - Leon FA Wymenga
- Department of Urology, Martini Hospital, NL-9700 Groningen, The Netherlands
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