基于人工智能的模型，用于肝移植后肝细胞癌复发
Artificial intelligence-based model for the recurrence of hepatocellular carcinoma after liver transplantation
影响因子:2.70000
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
摘要
基于人工智能的模型可以改善肝细胞癌中肝移植的患者选择。当前研究的目的是开发基于人工智能的深度学习模型，并确定肝细胞癌的活供体肝移植后复发的风险。这项研究是一项单中心回顾性同类研究。接受肝细胞癌的活供体肝移植的患者分为训练和验证队列（n = 192）。深度学习模型用于将培训队列中的患者分类为低风险组，并在验证队列中评估了5年的无复发生存期。中位随访期为59.1（33.9-72.4）月。人工智能模型（移植预后因素）在训练队列中的曲线下方为0.86，在验证队列中的面积为0.71。最大的肿瘤直径和α-毒素水平具有最大的Shapley添加性解释值（> 0.4）。低风险和高风险组的5年无复发生存率为92.6％和45％（p <.001）。在第二个人工智能模型（前植物因子+等级）中，验证队列曲线下的面积为0.77，低风险和高风险组的5年无复发生存率为96％和30％（p <.001）。在随访期间，米兰和加利福尼亚大学旧金山标准之外的低风险患者都没有复发。基于人工智能的肝细胞癌移植复发模型可以改善患者选择肝移植的患者选择。
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.