Objective: Pulmonary metastasis (PM) is an independent risk factor affecting the prognosis of cervical patients, but it still lacks a prediction. This study aimed to develop machine learning-based predictive models for PM. Methods: A total of 22,766 patients diagnosed with or without PM from the Surveillance, Epidemiology, and End Results (SEER) database were enrolled in this study. The cohort was randomly split into a train set (70%) and a validation set (30%). In addition, 884 Chinese patients from two tertiary medical centers were included as an external validation set. Duplicated and useless candidate variables were excluded, and sixteen variables were included for the machine learning algorithm. We developed five predictive models, including the generalized linear model (GLM), random forest model (RFM), naive Bayesian model (NBM), artificial neural networks model (ANNM), and decision tree model (DTM). The predictive performance of these models was evaluated by the receiver operating characteristic (ROC) curve and calibration curve. The Cox proportional hazard model (CPHM) and competing risk model (CRM) were also included for survival outcome prediction. Results: Of the patients included in the analysis, 2456 (4.38%) patients were diagnosed with PM. Age, organ-site metastasis (liver, bone, brain), distant lymph metastasis, tumor size, and pathology were the important predictors of PM. The RFM with 9 variables introduced was identified as the best predictive model for PM (AUC = 0.972, 95% CI: 0.958-0.986). The C-index for the CPHM and CRM was 0.626 (95% CI: 0.604-0.648) and 0.611 (95% CI: 0.586-0.636), respectively. Conclusion: The prediction algorithm derived by machine-learning-based methods shows a robust ability to predict PM. This result suggests that machine learning techniques have the potential to improve the development and validation of predictive modeling in cervical patients with PM.
第一作者单位:[1]Hubei Minzu Univ, Affiliated Enshi Clin Med Sch, Dept Anesthesiol, Cent Hosp Enshi Tujia & Miao Autonomous Prefectur, Enshi 445000, Hubei, Peoples R China
通讯作者:
通讯机构:[1]Hubei Minzu Univ, Affiliated Enshi Clin Med Sch, Dept Anesthesiol, Cent Hosp Enshi Tujia & Miao Autonomous Prefectur, Enshi 445000, Hubei, Peoples R China[6]Hubei Minzu Univ, Cent Hosp Enshi Tujia & Miao Autonomous Prefectur, Dept Pulm & Crit Care Med, Affiliated Enshi Clin Med Sch, Enshi 445000, Hubei, Peoples R China[7]Hubei Minzu Univ, Cent Hosp Enshi Tujia & Miao Autonomous Prefectur, Dept Oncol, Affiliated Enshi Clin Med Sch, Enshi 445000, Hubei, Peoples R China
推荐引用方式(GB/T 7714):
Zhu Menglin,Wang Bo,Wang Tiejun,et al.Risk Assessment of Pulmonary Metastasis for Cervical Cancer Patients by Ensemble Learning Models: A Large Population Based Real-World Study[J].INTERNATIONAL JOURNAL OF GENERAL MEDICINE.2021,14:8713-8723.doi:10.2147/IJGM.S338389.
APA:
Zhu, Menglin,Wang, Bo,Wang, Tiejun,Chen, Yilin&He, Du.(2021).Risk Assessment of Pulmonary Metastasis for Cervical Cancer Patients by Ensemble Learning Models: A Large Population Based Real-World Study.INTERNATIONAL JOURNAL OF GENERAL MEDICINE,14,
MLA:
Zhu, Menglin,et al."Risk Assessment of Pulmonary Metastasis for Cervical Cancer Patients by Ensemble Learning Models: A Large Population Based Real-World Study".INTERNATIONAL JOURNAL OF GENERAL MEDICINE 14.(2021):8713-8723