基于人工智能的肝细胞癌肝移植后复发模型
Artificial intelligence-based model for the recurrence of hepatocellular carcinoma after liver transplantation
DOI 原文链接
用sci-hub下载
如无法下载，请从 Sci-Hub 选择可用站点尝试。
影响因子:2.7
分区:医学2区 / 外科2区
发表日期:2024 Nov
作者:
Abdullah Altaf, Ahmed Mustafa, Abdullah Dar, Rashid Nazer, Shahzad Riyaz, Atif Rana, Abu Bakar Hafeez Bhatti
DOI:
10.1016/j.surg.2024.07.039
摘要
基于人工智能的模型可能有助于改善肝细胞癌患者的肝移植选择。本研究旨在开发基于人工智能的深度学习模型，并评估肝细胞癌在活体供体肝移植后复发的风险。本研究为单中心回顾性队列研究。接受肝细胞癌活体供体肝移植的患者被分为训练组和验证组（n = 192）。深度学习模型被用来将训练组患者分为低风险组和高风险组，并在验证组中评估5年无复发生存率。中位随访时间为59.1（33.9-72.4）个月。人工智能模型（移植前因素）在训练组的曲线下面积为0.86，在验证组为0.71。最大肿瘤直径和甲胎蛋白水平对复发的Shapley加性解释值最大（>0.4）。低风险组和高风险组的5年无复发生存率分别为92.6%和45%（P < .001）。在第二个人工智能模型（移植前因素+等级）中，验证组的曲线下面积为0.77，低风险组和高风险组的5年无复发生存率分别为96%和30%（P < .001）。在随访期间，没有低风险患者在米兰标准和加州大学旧金山分校标准之外发生复发。基于人工智能的肝细胞癌移植复发模型可能会改善肝移植的患者筛选。
Abstract
Artificial intelligence-based models might improve patient selection for liver transplantation in hepatocellular carcinoma. The objective of the current study was to develop artificial intelligence-based deep learning models and determine the risk of recurrence after living donor liver transplantation for hepatocellular carcinoma.The study was a single-center retrospective cohort study. Patients who underwent living donor liver transplantation for hepatocellular carcinoma were divided into training and validation cohorts (n = 192). The deep learning models were used to stratify patients in the training cohort into low- and high-risk groups, and 5-year recurrence-free survival was assessed in the validation cohort.The median follow-up period was 59.1 (33.9-72.4) months. The artificial intelligence model (pretransplant factors) had an area under the curve of 0.86 in the training cohort and 0.71 in the validation cohort. The largest tumor diameter and alpha-fetoprotein level had the greatest Shapley Additive exPlanations values for recurrence (>0.4). The 5-year recurrence-free survival rates in the low- and high-risk groups were 92.6% and 45% (P < .001). In the second artificial intelligence model (pretransplant factors + grade), the area under the curve for the validation cohort was 0.77, with 5-year recurrence-free survival rates of 96% and 30% in the low- and high-risk groups (P < .001). None of the low-risk patients outside the Milan and University of California San Francisco Criteria had recurrence during follow-up.The artificial intelligence-based hepatocellular carcinoma transplant recurrence models might improve patient selection for liver transplantation.