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Wang L, Fatemi M, Alizad A. Artificial intelligence techniques in liver cancer. Front Oncol 2024; 14:1415859. [PMID: 39290245 PMCID: PMC11405163 DOI: 10.3389/fonc.2024.1415859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 08/15/2024] [Indexed: 09/19/2024] Open
Abstract
Hepatocellular Carcinoma (HCC), the most common primary liver cancer, is a significant contributor to worldwide cancer-related deaths. Various medical imaging techniques, including computed tomography, magnetic resonance imaging, and ultrasound, play a crucial role in accurately evaluating HCC and formulating effective treatment plans. Artificial Intelligence (AI) technologies have demonstrated potential in supporting physicians by providing more accurate and consistent medical diagnoses. Recent advancements have led to the development of AI-based multi-modal prediction systems. These systems integrate medical imaging with other modalities, such as electronic health record reports and clinical parameters, to enhance the accuracy of predicting biological characteristics and prognosis, including those associated with HCC. These multi-modal prediction systems pave the way for predicting the response to transarterial chemoembolization and microvascular invasion treatments and can assist clinicians in identifying the optimal patients with HCC who could benefit from interventional therapy. This paper provides an overview of the latest AI-based medical imaging models developed for diagnosing and predicting HCC. It also explores the challenges and potential future directions related to the clinical application of AI techniques.
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Affiliation(s)
- Lulu Wang
- Department of Engineering, School of Technology, Reykjavık University, Reykjavík, Iceland
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine and Science, Rochester, MN, United States
| | - Mostafa Fatemi
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine and Science, Rochester, MN, United States
| | - Azra Alizad
- Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, MN, United States
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Xu Y, Zhang B, Zhou F, Yi YP, Yang XL, Ouyang X, Hu H. Development of machine learning-based personalized predictive models for risk evaluation of hepatocellular carcinoma in hepatitis B virus-related cirrhosis patients with low levels of serum alpha-fetoprotein. Ann Hepatol 2024; 29:101540. [PMID: 39151891 DOI: 10.1016/j.aohep.2024.101540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/31/2024] [Accepted: 06/05/2024] [Indexed: 08/19/2024]
Abstract
INTRODUCTION AND OBJECTIVES The increasing incidence of hepatocellular carcinoma (HCC) in China is an urgent issue, necessitating early diagnosis and treatment. This study aimed to develop personalized predictive models by combining machine learning (ML) technology with a demographic, medical history, and noninvasive biomarker data. These models can enhance the decision-making capabilities of physicians for HCC in hepatitis B virus (HBV)-related cirrhosis patients with low serum alpha-fetoprotein (AFP) levels. PATIENTS AND METHODS A total of 6,980 patients treated between January 2012 and December 2018 were included. Pre-treatment laboratory tests and clinical data were obtained. The significant risk factors for HCC were identified, and the relative risk of each variable affecting its diagnosis was calculated using ML and univariate regression analysis. The data set was then randomly partitioned into validation (20 %) and training sets (80 %) to develop the ML models. RESULTS Twelve independent risk factors for HCC were identified using Gaussian naïve Bayes, extreme gradient boosting (XGBoost), random forest, and least absolute shrinkage and selection operation regression models. Multivariate analysis revealed that male sex, age >60 years, alkaline phosphate >150 U/L, AFP >25 ng/mL, carcinoembryonic antigen >5 ng/mL, and fibrinogen >4 g/L were the risk factors, whereas hypertension, calcium <2.25 mmol/L, potassium ≤3.5 mmol/L, direct bilirubin >6.8 μmol/L, hemoglobin <110 g/L, and glutamic-pyruvic transaminase >40 U/L were the protective factors in HCC patients. Based on these factors, a nomogram was constructed, showing an area under the curve (AUC) of 0.746 (sensitivity = 0.710, specificity=0.646), which was significantly higher than AFP AUC of 0.658 (sensitivity = 0.462, specificity=0.766). Compared with several ML algorithms, the XGBoost model had an AUC of 0.832 (sensitivity = 0.745, specificity=0.766) and an independent validation AUC of 0.829 (sensitivity = 0.766, specificity = 0.737), making it the top-performing model in both sets. The external validation results have proven the accuracy of the XGBoost model. CONCLUSIONS The proposed XGBoost demonstrated a promising ability for individualized prediction of HCC in HBV-related cirrhosis patients with low-level AFP.
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Affiliation(s)
- Yuan Xu
- Medical Big Data Center, the Second Affiliated Hospital of Nanchang University, Nanchang, PR China
| | - Bei Zhang
- Department of Gastroenterology, the Second Affiliated Hospital of Nanchang University, Nanchang, PR China
| | - Fan Zhou
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, PR China
| | - Ying-Ping Yi
- Medical Big Data Center, the Second Affiliated Hospital of Nanchang University, Nanchang, PR China
| | - Xin-Lei Yang
- Medical Big Data Center, the Second Affiliated Hospital of Nanchang University, Nanchang, PR China
| | - Xiao Ouyang
- Quiclinic Technology Co., Ltd., Nanchang, PR China
| | - Hui Hu
- Medical Big Data Center, the Second Affiliated Hospital of Nanchang University, Nanchang, PR China.
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Shi W, Yan H, Liu X, Yu L, Xie Y, Wu Y, Liang Y, Yang Z. Development and Validation of a Novel Prognostic Nomogram Based on Platelet and CD8 +T Cell Counts in Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombosis. J Hepatocell Carcinoma 2024; 11:1049-1063. [PMID: 38863997 PMCID: PMC11166160 DOI: 10.2147/jhc.s452688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 05/09/2024] [Indexed: 06/13/2024] Open
Abstract
Purpose Portal vein tumor thrombosis (PVTT) is one of the hallmarks of advanced Hepatocellular carcinoma (HCC). Platelet (PLT) function parameters and CD8+T cells (CD8+Ts) play an important role in HCC progression and metastasis. This study is committed to establishing an efficient prognosis prediction model and exploring the combined effect of PLT and CD8+Ts on PVTT prognosis. Patients and Methods This retrospective study collected 932 HCC patients with PVTT from 2007 to 2017 and randomly divided them into a training cohort (n = 656) and a validation cohort (n = 276). We performed multivariable Cox and Elastic-net regression analysis, constructed a nomogram and used Kaplan-Meier survival curves to compare overall survival and progression-free survival rates in different substrata. Relationships between indicators involved were also analyzed. Results We found tumor number, size, treatment, PLT, γ-glutamyl transferase, alpha-fetoprotein, mean platelet volume, and CD8+Ts were related to the 5-year OS of patients with PVTT, and established a nomogram. The area under the receiver operating characteristic curve (AUCs) for predicting the 1-year OS rates were 0.767 and 0.794 in training and validation cohorts. The calibration curve and decision curve indicated its predictive consistency and strong clinical utility. We also found those with low PLT (<100*10^9/L) and high CD8+Ts (>320 cells/μL) had a better prognosis. Conclusion We established a well-performing prognostic model for PVTT based on platelet functional parameters and CD8+Ts, and found that PT-8 formed by PLT and CD8+Ts was an excellent predictor of the prognosis of PVTT.
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Affiliation(s)
- Wanxin Shi
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
- First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Huiwen Yan
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xiaoli Liu
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Lihua Yu
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yuqing Xie
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yuan Wu
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yuling Liang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Zhiyun Yang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
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Qian GX, Xu ZL, Li YH, Lu JL, Bu XY, Wei MT, Jia WD. Computed tomography-based radiomics to predict early recurrence of hepatocellular carcinoma post-hepatectomy in patients background on cirrhosis. World J Gastroenterol 2024; 30:2128-2142. [PMID: 38681988 PMCID: PMC11045480 DOI: 10.3748/wjg.v30.i15.2128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/08/2024] [Accepted: 03/12/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The prognosis for hepatocellular carcinoma (HCC) in the presence of cirrhosis is unfavourable, primarily attributable to the high incidence of recurrence. AIM To develop a machine learning model for predicting early recurrence (ER) of post-hepatectomy HCC in patients with cirrhosis and to stratify patients' overall survival (OS) based on the predicted risk of recurrence. METHODS In this retrospective study, 214 HCC patients with cirrhosis who underwent curative hepatectomy were examined. Radiomics feature selection was conducted using the least absolute shrinkage and selection operator and recursive feature elimination methods. Clinical-radiologic features were selected through univariate and multivariate logistic regression analyses. Five machine learning methods were used for model comparison, aiming to identify the optimal model. The model's performance was evaluated using the receiver operating characteristic curve [area under the curve (AUC)], calibration, and decision curve analysis. Additionally, the Kaplan-Meier (K-M) curve was used to evaluate the stratification effect of the model on patient OS. RESULTS Within this study, the most effective predictive performance for ER of post-hepatectomy HCC in the background of cirrhosis was demonstrated by a model that integrated radiomics features and clinical-radiologic features. In the training cohort, this model attained an AUC of 0.844, while in the validation cohort, it achieved a value of 0.790. The K-M curves illustrated that the combined model not only facilitated risk stratification but also exhibited significant discriminatory ability concerning patients' OS. CONCLUSION The combined model, integrating both radiomics and clinical-radiologic characteristics, exhibited excellent performance in HCC with cirrhosis. The K-M curves assessing OS revealed statistically significant differences.
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Affiliation(s)
- Gui-Xiang Qian
- Department of Hepatic Surgery, Anhui Provincial Hospital, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
| | - Zi-Ling Xu
- Department of Hepatic Surgery, Anhui Provincial Hospital Affiliated to Anhui Medical University, Anhui Medical University, Hefei 230001, Anhui Province, China
| | - Yong-Hai Li
- Department of Anorectal Surgery, the First People’s Hospital of Hefei, Hefei 230001, Anhui Province, China
| | - Jian-Lin Lu
- Department of Hepatic Surgery, Anhui Provincial Hospital Affiliated to Anhui Medical University, Anhui Medical University, Hefei 230001, Anhui Province, China
| | - Xiang-Yi Bu
- Department of Hepatic Surgery, Anhui Provincial Hospital, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
| | - Ming-Tong Wei
- Department of Hepatic Surgery, Anhui Provincial Hospital Affiliated to Anhui Medical University, Anhui Medical University, Hefei 230001, Anhui Province, China
| | - Wei-Dong Jia
- Department of Hepatic Surgery, Anhui Provincial Hospital, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
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Yao N, Liu Y, Xu J, Wang Q, Zhou Q, Wang Y, Yi D, Wu Y. Identification of associated risk factors for serological distribution of hepatitis B virus via machine learning models. BMC Infect Dis 2024; 24:66. [PMID: 38195403 PMCID: PMC10775609 DOI: 10.1186/s12879-023-08911-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/14/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND The provincial-level sero-survey was launched to learn the updated seroprevalence of hepatitis B virus (HBV) infection in the general population aged 1-69 years in Chongqing and to assess the risk factors for HBV infection to effectively screen persons with chronic hepatitis B (CHB). METHODS A total of 1828 individuals aged 1-69 years were investigated, and hepatitis B surface antigen (HBsAg), antibody to HBsAg (HBsAb), and antibody to B core antigen (HBcAb) were detected. Logistic regression and three machine learning (ML) algorithms, including random forest (RF), support vector machine (SVM), and stochastic gradient boosting (SGB), were developed for analysis. RESULTS The HBsAg prevalence of the total population was 3.83%, and among persons aged 1-14 years and 15-69 years, it was 0.24% and 4.89%, respectively. A large figure of 95.18% (770/809) of adults was unaware of their occult HBV infection. Age, region, and immunization history were found to be statistically associated with HBcAb prevalence with a logistic regression model. The prediction accuracies were 0.717, 0.727, and 0.725 for the proposed RF, SVM, and SGB models, respectively. CONCLUSIONS The logistic regression integrated with ML models could helpfully screen the risk factors for HBV infection and identify high-risk populations with CHB.
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Affiliation(s)
- Ning Yao
- Department of Health Statistics, College of Preventive Medicine, Army Medical University, NO.30 Gaotanyan Street, Shapingba District, Chongqing, 400038, China
- Chongqing Center for Disease Control and Prevention, NO.8 Changjiang 2nd Street, Yuzhong District, Chongqing, 400042, China
| | - Yang Liu
- Chongqing Center for Disease Control and Prevention, NO.8 Changjiang 2nd Street, Yuzhong District, Chongqing, 400042, China
| | - Jiawei Xu
- Chongqing Center for Disease Control and Prevention, NO.8 Changjiang 2nd Street, Yuzhong District, Chongqing, 400042, China
| | - Qing Wang
- Chongqing Center for Disease Control and Prevention, NO.8 Changjiang 2nd Street, Yuzhong District, Chongqing, 400042, China
| | - Quanhua Zhou
- Chongqing Center for Disease Control and Prevention, NO.8 Changjiang 2nd Street, Yuzhong District, Chongqing, 400042, China
| | - Yue Wang
- Chongqing Center for Disease Control and Prevention, NO.8 Changjiang 2nd Street, Yuzhong District, Chongqing, 400042, China
| | - Dong Yi
- Department of Health Statistics, College of Preventive Medicine, Army Medical University, NO.30 Gaotanyan Street, Shapingba District, Chongqing, 400038, China.
| | - Yazhou Wu
- Department of Health Statistics, College of Preventive Medicine, Army Medical University, NO.30 Gaotanyan Street, Shapingba District, Chongqing, 400038, China.
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Wu R, Luo J, Wan H, Zhang H, Yuan Y, Hu H, Feng J, Wen J, Wang Y, Li J, Liang Q, Gan F, Zhang G. Evaluation of machine learning algorithms for the prognosis of breast cancer from the Surveillance, Epidemiology, and End Results database. PLoS One 2023; 18:e0280340. [PMID: 36701415 PMCID: PMC9879508 DOI: 10.1371/journal.pone.0280340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 12/26/2022] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Many researchers used machine learning (ML) to predict the prognosis of breast cancer (BC) patients and noticed that the ML model had good individualized prediction performance. OBJECTIVE The cohort study was intended to establish a reliable data analysis model by comparing the performance of 10 common ML algorithms and the the traditional American Joint Committee on Cancer (AJCC) stage, and used this model in Web application development to provide a good individualized prediction for others. METHODS This study included 63145 BC patients from the Surveillance, Epidemiology, and End Results database. RESULTS Through the performance of the 10 ML algorithms and 7th AJCC stage in the optimal test set, we found that in terms of 5-year overall survival, multivariate adaptive regression splines (MARS) had the highest area under the curve (AUC) value (0.831) and F1-score (0.608), and both sensitivity (0.737) and specificity (0.772) were relatively high. Besides, MARS showed a highest AUC value (0.831, 95%confidence interval: 0.820-0.842) in comparison to the other ML algorithms and 7th AJCC stage (all P < 0.05). MARS, the best performing model, was selected for web application development (https://w12251393.shinyapps.io/app2/). CONCLUSIONS The comparative study of multiple forecasting models utilizing a large data noted that MARS based model achieved a much better performance compared to other ML algorithms and 7th AJCC stage in individualized estimation of survival of BC patients, which was very likely to be the next step towards precision medicine.
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Affiliation(s)
- Ruiyang Wu
- Department of Breast and Thyroid Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children’s Hospital of Chengdu Medical College), Chengdu, China
| | - Jing Luo
- Department of Breast and Thyroid Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children’s Hospital of Chengdu Medical College), Chengdu, China
| | - Hangyu Wan
- Department of Breast and Thyroid Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children’s Hospital of Chengdu Medical College), Chengdu, China
| | - Haiyan Zhang
- Department of Breast and Thyroid Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children’s Hospital of Chengdu Medical College), Chengdu, China
| | - Yewei Yuan
- Department of Breast and Thyroid Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children’s Hospital of Chengdu Medical College), Chengdu, China
| | - Huihua Hu
- Department of Breast and Thyroid Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children’s Hospital of Chengdu Medical College), Chengdu, China
| | - Jinyan Feng
- Department of Breast and Thyroid Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children’s Hospital of Chengdu Medical College), Chengdu, China
| | - Jing Wen
- Department of Breast and Thyroid Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children’s Hospital of Chengdu Medical College), Chengdu, China
| | - Yan Wang
- Department of Breast and Thyroid Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children’s Hospital of Chengdu Medical College), Chengdu, China
| | - Junyan Li
- Department of Breast and Thyroid Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children’s Hospital of Chengdu Medical College), Chengdu, China
| | - Qi Liang
- Department of Breast and Thyroid Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children’s Hospital of Chengdu Medical College), Chengdu, China
| | - Fengjiao Gan
- Department of Breast and Thyroid Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children’s Hospital of Chengdu Medical College), Chengdu, China
| | - Gang Zhang
- Department of Breast and Thyroid Surgery, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children’s Hospital of Chengdu Medical College), Chengdu, China
- * E-mail:
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Hu J, Wang Y, Deng L, Yu H, Chen K, Bao W, Chen K, Chen G. Development and validation of a nomogram for predicting the cancer-specific survival of fibrolamellar hepatocellular carcinoma patients. Updates Surg 2022; 74:1589-1599. [PMID: 35713784 DOI: 10.1007/s13304-022-01308-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 05/21/2022] [Indexed: 11/24/2022]
Abstract
Fibrolamellar hepatocellular carcinoma (FLC) is a rare subtype of hepatocellular carcinoma. Our study aimed to construct a nomogram to predict the cancer-specific survival (CSS) of FLC. Data of 200 FLC patients enrolled in the Surveillance, Epidemiology, and End Results (SEER) database were divided into the training group and the validation group. Prognostic factors identified in the univariate and multivariate Cox regression analyses were used to construct the nomogram. The concordance index (C-index), calibration curves, time-dependent receiver operating characteristic curve (ROC), and decision curve analysis (DCA) were used to evaluate the performance of the nomogram. As a result, age ≥ 59, N1 stage, M1 stage, tumor size ≤ 2.0 cm, and no surgery were significantly associated with lower CSS in multivariate Cox regression analysis. The calibration plot showed good consistency of the nomogram between predicted and observed outcomes in the training and validation groups. Compared with the TNM staging system, the prognostic evaluation model (PEM) showed a higher C-index (0.823 vs 0.656). The PEM also showed better predictive performance, with areas under the curve of 0.909 and 0.890 for predicting the 1- and 5-year survival. The AUCs of the TNM stage model for predicting 1- and 5-year survival were 0.629 and 0.787, respectively. In addition, the DCA curve showed that the nomogram had better clinical utility. Finally, we concluded that Age, N stage, M stage, tumor size, and surgery are independent prognostic factors for FLC. PEM established based on these five prognostic indicators can help predict the CSS of patients with FLC.
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Affiliation(s)
- Jiawei Hu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Fuxue Road, Wenzhou, Zhejiang, 325035, People's Republic of China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, People's Republic of China
| | - Yi Wang
- Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, 325035, People's Republic of China
| | - Liming Deng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Fuxue Road, Wenzhou, Zhejiang, 325035, People's Republic of China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, People's Republic of China
| | - Haitao Yu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Fuxue Road, Wenzhou, Zhejiang, 325035, People's Republic of China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, People's Republic of China
| | - Kaiyu Chen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Fuxue Road, Wenzhou, Zhejiang, 325035, People's Republic of China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, People's Republic of China
| | - Wenming Bao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Fuxue Road, Wenzhou, Zhejiang, 325035, People's Republic of China.,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, People's Republic of China
| | - Kaiwen Chen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Fuxue Road, Wenzhou, Zhejiang, 325035, People's Republic of China
| | - Gang Chen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Fuxue Road, Wenzhou, Zhejiang, 325035, People's Republic of China. .,Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325035, People's Republic of China.
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Liu X, Wang X, Yu L, Hou Y, Jiang Y, Wang X, Han J, Yang Z. A Novel Prognostic Score Based on Artificial Intelligence in Hepatocellular Carcinoma: A Long-Term Follow-Up Analysis. Front Oncol 2022; 12:817853. [PMID: 35712507 PMCID: PMC9195097 DOI: 10.3389/fonc.2022.817853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Objective T cell immunity plays an important role in anti-tumor effects and immunosuppression often leads to the development and relapse of cancer. This study aimed to investigate the effect of T cell numbers on the long-term prognosis of patients with hepatocellular carcinoma (HCC) and construct an artificial neural network (ANN) model to evaluate its prognostic value. Methods We enrolled 3,427 patients with HCC at Beijing Ditan Hospital, Capital Medical University, and randomly divided them into two groups of 1,861 and 809 patients as the training and validation sets, respectively. Cox regression analysis was used to screen for independent risk factors of survival in patients with HCC. These factors were used to build an ANN model using Python. Concordance index, calibration curve, and decision curve analysis were used to evaluate the model performance. Results The 1-year, 3-year, 5-year, and 10-year cumulative overall survival (OS) rates were 66.9%, 45.7%, 34.9%, and 22.6%, respectively. Cox multivariate regression analysis showed that age, white blood cell count, creatinine, total bilirubin, γ-GGT, LDH, tumor size ≥ 5 cm, tumor number ≥ 2, portal vein tumor thrombus, and AFP ≥ 400 ng/ml were independent risk factors for long-term survival in HCC. Antiviral therapy, albumin, T cell, and CD8 T cell counts were independent protective factors. An ANN model was developed for long-term survival. The areas under the receiver operating characteristic (ROC) curve of 1-year, 3-year, and 5-year OS rates by ANNs were 0.838, 0.833, and 0.843, respectively, which were higher than those of the Barcelona Clinic Liver Cancer (BCLC), tumor node metastasis (TNM), Okuda, Chinese University Prognostic Index (CUPI), Cancer of the Liver Italian Program (CLIP), Japan Integrated Staging (JIS), and albumin–bilirubin (ALBI) models (P < 0.0001). According to the ANN model scores, all patients were divided into high-, middle-, and low-risk groups. Compared with low-risk patients, the hazard ratios of 5-year OS of the high-risk group were 8.11 (95% CI: 7.0-9.4) and 6.13 (95% CI: 4.28-8.79) (P<0.0001) in the training and validation sets, respectively. Conclusion High levels of circulating T cells and CD8 + T cells in peripheral blood may benefit the long-term survival of patients with HCC. The ANN model has a good individual prediction performance, which can be used to assess the prognosis of HCC and lay the foundation for the implementation of precision treatment in the future.
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Affiliation(s)
- Xiaoli Liu
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xinhui Wang
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Lihua Yu
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yixin Hou
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yuyong Jiang
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xianbo Wang
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Junyan Han
- Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Junyan Han, ; Zhiyun Yang,
| | - Zhiyun Yang
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Junyan Han, ; Zhiyun Yang,
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Alpha-Fetoprotein+Alkaline Phosphatase (A-A) Score Can Predict the Prognosis of Patients with Ruptured Hepatocellular Carcinoma Underwent Hepatectomy. DISEASE MARKERS 2022; 2022:9934189. [PMID: 35493302 PMCID: PMC9050275 DOI: 10.1155/2022/9934189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 04/01/2022] [Indexed: 11/23/2022]
Abstract
Background This research is aimed at establishing a scoring system alpha-fetoprotein+alkaline phosphatase (A-A score) based on preoperative serum alpha-fetoprotein (AFP) and alkaline phosphatase (ALP) levels and to investigate its clinical significance in patients with ruptured hepatocellular carcinoma (rHCC) after hepatectomy. Methods 175 ruptured hepatocellular carcinoma (HCC) patients treated with hepatectomy were included. Survival analysis was assessed by the Kaplan-Meier method. Prognostic factors were analyzed in a multivariate model. Preoperative serum AFP and ALP values are assigned a score of 1 if they exceed the threshold value and 0 if they are below the threshold value, A-A score is obtained by summing the scores of two variables (AFP, ALP), and the predictive values of AFP, ALP, and A-A score were compared by receiver operating characteristic curve (ROC) analysis, and subgroup analyses were performed to further evaluate the power of A-A scores. Results Of the 175 patients, 67 (38.3%) had an A-A score of 0, 72 (41.1%) had an A-A score of 1, and 36 (20.6%) had an A-A score of 2. In multivariate analysis, the A-A score, the BCLC stage, and the extent of resection were independent predictors of OS in patients with rHCC. The 1-, 3-, and 5-year OS and RFS in patients with an A-A score of 1 were better than those with an A-A score of 0 and worse than those with an A-A score of 1 (all p < 0.05). Based on the results of ROC analysis, the A-A score is superior to AFP or ALP alone in predicting the prognosis of patients with ruptured HCC. In subgroup analysis, A-A score could accurately predict the prognosis of patients with or without microvascular invasion (MVI) and with different Child-Pugh grades or gender. Conclusions The A-A score can effectively predict the prognosis of patients after hepatectomy of ruptured hepatocellular carcinoma. At the same time, it also has good evaluation ability in different subgroups.
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Nomogram for prediction of long-term survival with hepatocellular carcinoma based on NK cell counts. Ann Hepatol 2022; 27:100672. [PMID: 35065261 DOI: 10.1016/j.aohep.2022.100672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/13/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Among all immune cells, natural killer (NK) cells play an important role as the first line of defense against tumor. The purpose of our study is to observe whether the NK cell counts can predict the overall survival of patients with hepatocellular carcinoma (HCC). METHODS To develop a novel model, from January 2010 to June 2015, HCC patients enrolled in Beijing Ditan hospital were divided into training and validation cohort. Cox multiple regression analysis was used to analyze the independent risk factors for 1-year, 3-year and 5-year overall survival (OS) of patients with HCC, and the nomogram was used to establish the prediction model. In addition, the decision tree was established to verify the contribution of NK cell counts to the survival of patients with HCC. RESULTS The model used in predicting overall survival of HCC included six variables (namely, NK cell counts, albumin (ALB) level, alpha-fetoprotein (AFP) level, portal vein tumor thrombus (PVTT), tumor number and treatment). The C-index of nomogram model in HCC patients predicting 1-year, 3-year and 5-year overall survival was 0.858, 0.788 and 0.782 respectively, which was higher than tumor-lymph node-metastasis (TNM) staging system, Okuda, model for end-stage liver disease (MELD), MELD-Na, the Chinese University Prognostic Index (CUPI) and Japan Integrated Staging (JIS) scores (p < 0.001). The decision tree showed the specific 5-year OS probability of HCC patients under different risk factors, and found that NK cell counts were the third in the column contribution. CONCLUSIONS Our study emphasizes the utility of NK cell counts for exploring interactions between long-term survival of HCC patients and predictor variables.
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Christou CD, Tsoulfas G. Role of three-dimensional printing and artificial intelligence in the management of hepatocellular carcinoma: Challenges and opportunities. World J Gastrointest Oncol 2022; 14:765-793. [PMID: 35582107 PMCID: PMC9048537 DOI: 10.4251/wjgo.v14.i4.765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 08/24/2021] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) constitutes the fifth most frequent malignancy worldwide and the third most frequent cause of cancer-related deaths. Currently, treatment selection is based on the stage of the disease. Emerging fields such as three-dimensional (3D) printing, 3D bioprinting, artificial intelligence (AI), and machine learning (ML) could lead to evidence-based, individualized management of HCC. In this review, we comprehensively report the current applications of 3D printing, 3D bioprinting, and AI/ML-based models in HCC management; we outline the significant challenges to the broad use of these novel technologies in the clinical setting with the goal of identifying means to overcome them, and finally, we discuss the opportunities that arise from these applications. Notably, regarding 3D printing and bioprinting-related challenges, we elaborate on cost and cost-effectiveness, cell sourcing, cell viability, safety, accessibility, regulation, and legal and ethical concerns. Similarly, regarding AI/ML-related challenges, we elaborate on intellectual property, liability, intrinsic biases, data protection, cybersecurity, ethical challenges, and transparency. Our findings show that AI and 3D printing applications in HCC management and healthcare, in general, are steadily expanding; thus, these technologies will be integrated into the clinical setting sooner or later. Therefore, we believe that physicians need to become familiar with these technologies and prepare to engage with them constructively.
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Affiliation(s)
- Chrysanthos D Christou
- Department of Transplantation Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54622, Greece
| | - Georgios Tsoulfas
- Department of Transplantation Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54622, Greece
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Huang CW, Wu TH, Hsu HY, Pan KT, Lee CW, Chong SW, Huang SF, Lin SE, Yu MC, Chen SM. Reappraisal of the Role of Alkaline Phosphatase in Hepatocellular Carcinoma. J Pers Med 2022; 12:jpm12040518. [PMID: 35455635 PMCID: PMC9030712 DOI: 10.3390/jpm12040518] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Alkaline phosphatase (ALP) is a marker of liver function and is associated with biliary tract disease. It was reported as a prognostic factor for hepatocellular carcinoma (HCC). The genetic expression in tumor-tissue microarrays and the perioperative serologic changes in ALP have never been studied for their correlation with HCC prognosis. Methods: The genetic expression of ALP isoforms (placental (ALPP), intestinal (ALPI) and bone/kidney/liver (ALPL)) was analyzed in tumor and non-cancerous areas in 38 patients with HCC after partial hepatectomy. The perioperative change in ALP was further analyzed in a cohort containing 525 patients with HCC to correlate it with oncologic outcomes. A total of 43 HCC patients were enrolled for a volumetry study after major and minor hepatectomy. Results: The genetic expression of the bone/kidney/liver isoform was specifically and significantly higher in non-cancerous areas than in tumors. Patients with HCC with a higher ALP (>81 U/dL) had significantly more major hepatectomies, vascular invasion, and recurrence. Cox regression analysis showed that gender, major hepatectomies, the presence of satellite lesions, higher grades (III or IV) and perioperative changes in liver function tests were independent prognostic factors for recurrence-free survival, and a postoperative increase in the ALP ratio at postoperative day (POD) 7 vs. POD 0 > 1.46 should be emphasized. A liver regeneration rate more than 1.8 and correlation analysis revealed that the ALP level at POD 7 and 30 was significantly higher and correlated with remnant liver growth. Conclusions: This study demonstrated that the perioperative ALP change was an independent prognostic factor for HCC after partial hepatectomies, and the elevation of ALP represented a functional biomarker for the liver but not an HCC biomarker. The higher regeneration capacity was possibly associated with the elevation of ALP after operation.
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Affiliation(s)
- Chun-Wei Huang
- Division of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, Taiwan; (C.-W.H.); (H.-Y.H.); (S.-W.C.); (S.-F.H.)
| | - Tsung-Han Wu
- Department of Surgery, Chang Gung Memorial Hospital, Linkou and Chang-Gung University, Taoyuan 33305, Taiwan; (T.-H.W.); (C.-W.L.)
| | - Heng-Yuan Hsu
- Division of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, Taiwan; (C.-W.H.); (H.-Y.H.); (S.-W.C.); (S.-F.H.)
| | - Kuang-Tse Pan
- Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan;
| | - Chao-Wei Lee
- Department of Surgery, Chang Gung Memorial Hospital, Linkou and Chang-Gung University, Taoyuan 33305, Taiwan; (T.-H.W.); (C.-W.L.)
| | - Sio-Wai Chong
- Division of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, Taiwan; (C.-W.H.); (H.-Y.H.); (S.-W.C.); (S.-F.H.)
| | - Song-Fong Huang
- Division of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, Taiwan; (C.-W.H.); (H.-Y.H.); (S.-W.C.); (S.-F.H.)
| | - Sey-En Lin
- Department of Pathology, New Taipei Municipal Tucheng Hospital, New Taipei 23652, Taiwan;
| | - Ming-Chin Yu
- Division of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, Taiwan; (C.-W.H.); (H.-Y.H.); (S.-W.C.); (S.-F.H.)
- Correspondence: (M.-C.Y.); (S.-M.C.)
| | - Shen-Ming Chen
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei 106, Taiwan
- Correspondence: (M.-C.Y.); (S.-M.C.)
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Andjelkovic J, Ljubic B, Hai AA, Stanojevic M, Pavlovski M, Diaz W, Obradovic Z. Sequential machine learning in prediction of common cancers. INFORMATICS IN MEDICINE UNLOCKED 2022. [DOI: 10.1016/j.imu.2022.100928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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He C, Zhao C, Zhang Y, Chen C, Lin X. An Inflammation-Index Signature Predicts Prognosis of Patients with Intrahepatic Cholangiocarcinoma After Curative Resection. J Inflamm Res 2021; 14:1859-1872. [PMID: 34012285 PMCID: PMC8128507 DOI: 10.2147/jir.s311084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/17/2021] [Indexed: 12/19/2022] Open
Abstract
Background The prognosis of patients with intrahepatic cholangiocarcinoma (ICC) after resection is at great variance. We aimed to establish a novel prognostic nomogram in facilitating the risk stratification for these patients. Methods A total of 82 high-dimensional radiological and pathological data were analyzed by LASSO-penalized Cox regression analyses and the panels with the best predictive performance were selected. Specific nomograms were established based on the selected panels and were validated in both primary (n=292) and validation cohorts (n=107). The area under the receiver operating characteristic curve (AUC) and the concordance index (C-index) were used to compare the predictive ability of nomograms and other staging systems. Results The modified Glasgow Prognostic Score (mGPS) was identified as the prognostic factor for both overall survival (OS) and progression-free survival (PFS). The nomograms built on the prognostic factors showed powerful efficacy in survival prediction, with C-indexes of 0.800 (95% CI 0.767-0.833) and 0.752 (95% CI 0.718-0.786) for OS and PFS in the primary cohort, 0.659 (95% CI 0.586-0.732) and 0.638 (95% CI 0.571-0.705) for OS and PFS in the validation cohort, respectively. Compared with tumor-node-metastasis stage, Barcelona Clinic Liver Cancer staging score, Cancer of the Liver Italian Program score, and Okuda staging system, the nomograms had significantly higher values of AUC and C-indexes in survival prediction in the primary and validation cohorts. Conclusion Compared with currently used staging systems, the nomograms showed significantly higher efficacy in predicting survival of ICC patients after resection. The nomograms provide new versions of personalized management for these patients.
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Affiliation(s)
- Chaobin He
- Department of Pancreatobiliary Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Chongyu Zhao
- Department of Pancreatobiliary Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
| | - Yu Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Cheng Chen
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Xiaojun Lin
- Department of Pancreatobiliary Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
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Zou ZM, Chang DH, Liu H, Xiao YD. Current updates in machine learning in the prediction of therapeutic outcome of hepatocellular carcinoma: what should we know? Insights Imaging 2021; 12:31. [PMID: 33675433 PMCID: PMC7936998 DOI: 10.1186/s13244-021-00977-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/15/2021] [Indexed: 12/24/2022] Open
Abstract
With the development of machine learning (ML) algorithms, a growing number of predictive models have been established for predicting the therapeutic outcome of patients with hepatocellular carcinoma (HCC) after various treatment modalities. By using the different combinations of clinical and radiological variables, ML algorithms can simulate human learning to detect hidden patterns within the data and play a critical role in artificial intelligence techniques. Compared to traditional statistical methods, ML methods have greater predictive effects. ML algorithms are widely applied in nearly all steps of model establishment, such as imaging feature extraction, predictive factor classification, and model development. Therefore, this review presents the literature pertaining to ML algorithms and aims to summarize the strengths and limitations of ML, as well as its potential value in prognostic prediction, after various treatment modalities for HCC.
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Affiliation(s)
- Zhi-Min Zou
- Department of Radiology, The Second Xiangya Hospital of Central South University, No.139 Middle Renmin Road, Changsha, 410011, China
| | - De-Hua Chang
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Hui Liu
- Department of Radiology, The Second Xiangya Hospital of Central South University, No.139 Middle Renmin Road, Changsha, 410011, China
| | - Yu-Dong Xiao
- Department of Radiology, The Second Xiangya Hospital of Central South University, No.139 Middle Renmin Road, Changsha, 410011, China.
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Sato M, Tateishi R, Yatomi Y, Koike K. Artificial intelligence in the diagnosis and management of hepatocellular carcinoma. J Gastroenterol Hepatol 2021; 36:551-560. [PMID: 33709610 DOI: 10.1111/jgh.15413] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/07/2021] [Accepted: 01/15/2021] [Indexed: 02/06/2023]
Abstract
Despite recent improvements in therapeutic interventions, hepatocellular carcinoma is still associated with a poor prognosis in patients with an advanced disease at diagnosis. Recently, significant progress has been made in image recognition through advances in the field of artificial intelligence (AI) (or machine learning), especially deep learning. AI is a multidisciplinary field that draws on the fields of computer science and mathematics for developing and implementing computer algorithms capable of maximizing the predictive accuracy from static or dynamic data sources using analytic or probabilistic models. Because of the multifactorial and complex nature of liver diseases, the machine learning approach to integrate multiple factors would appear to be an advantageous approach to improve the likelihood of making a precise diagnosis and predicting the response of treatment and prognosis of liver diseases. In this review, we attempted to summarize the potential use of AI in the diagnosis and management of liver diseases, especially hepatocellular carcinoma.
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Affiliation(s)
- Masaya Sato
- Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryosuke Tateishi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiko Koike
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Liu X, Lu J, Zhang G, Han J, Zhou W, Chen H, Zhang H, Yang Z. A Machine Learning Approach Yields a Multiparameter Prognostic Marker in Liver Cancer. Cancer Immunol Res 2021; 9:337-347. [PMID: 33431375 DOI: 10.1158/2326-6066.cir-20-0616] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/13/2020] [Accepted: 01/07/2021] [Indexed: 01/19/2023]
Abstract
A number of staging systems have been developed to predict clinical outcomes in hepatocellular carcinoma (HCC). However, no general consensus has been reached regarding the optimal model. New approaches such as machine learning (ML) strategies are powerful tools for incorporating risk factors from multiple platforms. We retrospectively reviewed the baseline information, including clinicopathologic characteristics, laboratory parameters, and peripheral immune features reflecting T-cell function, from three HCC cohorts. A gradient-boosting survival (GBS) classifier was trained with prognosis-related variables in the training dataset and validated in two independent cohorts. We constructed a 20-feature GBS model classifier incorporating one clinical feature, 14 laboratory parameters, and five T-cell function parameters obtained from peripheral blood mononuclear cells. The GBS model-derived risk scores demonstrated high concordance indexes (C-indexes): 0.844, 0.827, and 0.806 in the training set and validation sets 1 and 2, respectively. The GBS classifier could separate patients into high-, medium- and low-risk subgroups with respect to death in all datasets (P < 0.05 for all comparisons). A higher risk score was positively correlated with a higher clinical stage and the presence of portal vein tumor thrombus (PVTT). Subgroup analyses with respect to Child-Pugh class, Barcelona Clinic Liver Cancer stage, and PVTT status supported the prognostic relevance of the GBS-derived risk algorithm independent of the conventional tumor staging system. In summary, a multiparameter ML algorithm incorporating clinical characteristics, laboratory parameters, and peripheral immune signatures offers a different approach to identify patients with the greatest risk of HCC-related death.
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Affiliation(s)
- Xiaoli Liu
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China
| | - Jilin Lu
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, P.R. China
| | - Guanxiong Zhang
- Genecast Precision Medicine Technology Institute, Beijing, P.R. China
| | - Junyan Han
- Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China
| | - Wei Zhou
- Genecast Precision Medicine Technology Institute, Beijing, P.R. China
| | - Huan Chen
- Genecast Precision Medicine Technology Institute, Beijing, P.R. China.
| | - Henghui Zhang
- Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China.
| | - Zhiyun Yang
- Center for Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, P.R. China.
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