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中华结直肠疾病电子杂志 ›› 2024, Vol. 13 ›› Issue (05) : 389 -393. doi: 10.3877/cma.j.issn.2095-3224.2024.05.006

论著

随机森林模型预测T1 期结直肠癌淋巴结转移的初步研究
张伟伟1, 陈启1, 翁和语1, 黄亮,2   
  1. 1.211100 南京医科大学附属逸夫医院肛肠外科
    2.510655 广州,中山大学附属第六医院结直肠肛门外科
  • 收稿日期:2024-07-09 出版日期:2024-10-25
  • 通信作者: 黄亮
  • 基金资助:
    中山六院临床医学研究计划项目[No. 1010CG(2023)-07]

Preliminary study on prediction of lymph node metastasis of T1 colorectal cancer by random forest model

Weiwei Zhang1, Qi Chen1, Heyu Weng1, Liang Huang,2   

  1. 1.Department of Colorectal Surgery, Sir Run Run Hospital, Nanjing Medical University, Nanjing 211100, China
    2.Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat Sen University, Guangzhou 510655, China
  • Received:2024-07-09 Published:2024-10-25
  • Corresponding author: Liang Huang
引用本文:

张伟伟, 陈启, 翁和语, 黄亮. 随机森林模型预测T1 期结直肠癌淋巴结转移的初步研究[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(05): 389-393.

Weiwei Zhang, Qi Chen, Heyu Weng, Liang Huang. Preliminary study on prediction of lymph node metastasis of T1 colorectal cancer by random forest model[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2024, 13(05): 389-393.

目的

探索T1 期结直肠癌淋巴结转移的危险因素,建立预测T1 期结直肠癌患者淋巴结转移的随机森林模型。

方法

收集2010 年8 月至2020 年6 月于中山大学附属第六医院进行根治性手术治疗的280 例T1 期结直肠癌患者的临床资料,运用R 软件建立预测T1 期结直肠癌患者淋巴结转移的随机森林模型。

结果

T1 期结直肠癌淋巴结转移发生率为11.07%(31/280)。随机森林模型显示,T1 期结直肠癌发生淋巴结转移的危险因素重要性排序为:年龄、脉管神经浸润、肿瘤位置、分化程度、性别、肿瘤大小和Ki67。随机森林模型预测T1 期结直肠癌淋巴结转移曲线下面积(AUC)为0.811,最佳阈值是0.072,特异度和敏感度分别为0.703 和0.778。

结论

随机森林模型有助于临床医师快捷地分析T1 期结直肠癌淋巴结转移风险,并制定合适的治疗方案。

Objective

In order to explore the risk factors of lymph node metastasis of stage T1 colorectal cancer and establish a random forest model to predict lymph node metastasis of stage T1 colorectal cancer patients.

Methods

We collected the clinical data of 280 patients with stage T1 colorectal cancer who underwent radical surgery in the Sixth Affiliated Hospital of Sun Yat-sen University from August 2010 to June 2020,and established a random forest model to predict lymph node metastasis of stage T1 colorectal cancer patients by R software.

Results

The incidence of lymph node metastasis in T1 stage colorectal cancer was 11.07% (31/280). The importance ranking of risk factors following the random forest model for lymph node metastasis in stage T1 colorectal cancer was as follows: age,vascular or neural invasion,tumor location,differentiation degree,gender,tumor size,and Ki67 level. The area under the curve (AUC) of our random forest model for lymph node metastasis in stage T1 colorectal cancer was 0.811,with an optimal threshold of 0.072,specificity of 0.703 and sensitivity of 0.778.

Conclusion

The random forest model is helpful for clinicians to quickly analyze the risk of lymph node metastasis in stage T1 colorectal cancer and make appropriate treatment plans.

图1 T1 期结直肠癌发生淋巴结转移危险因素的重要性排序。注:Mean Decrease GiNi 表示基尼指数;Predictor 表示预测指标;AGE 表示年龄;V.N_Infi 表示血管神经浸润;Tum_loc 表示肿瘤位置;Dif_len 表示肿瘤分化程度;SEX表示性别;Tum_len 表示肿瘤大小
表1 训练组和测试组的基线资料比较[例(%)]
图2 随机森林预测模型的ROC 曲线图。注:Specificity表示特异度;Sensitivity 表示敏感度
图3 随机森林预测模型的校准曲线。注:Predicted Probability 表示预测概率;Observed Probability 表示实际概率
图4 随机森林预测模型的DCA。注:Cost:Benefit Ratio 表示成本收益比;High Risk Threshold 表示高风险阈值;Net Benefit 表示净收益值
图5 随机森林预测模型的CIC。注:Cost:Benefit Ratio 表示成本收益比;High Risk Threshold 表示高风险阈值;Number high risk(out of 1 000)表示高风险人数(‰)
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