The clinical value of artificial intelligence quantitative parameters in distinguishing pathological grades of stage Ⅰ invasive pulmonary adenocarcinoma
- VernacularTitle:人工智能量化参数鉴别Ⅰ期浸润性肺腺癌病理分级的临床价值
- Author:
Yun LIANG
1
;
Mengmeng REN
2
;
Delong HUANG
3
;
Jingyan DIAO
4
;
Xuri MU
4
;
Guowei ZHANG
3
;
Shuliang LIU
4
;
Xiuqu FEI
4
;
Dongmei DI
5
;
Ning XIE
4
Author Information
1. 1. Department of Thoracic Surgery, Yantaishan Hospital Affiliated to Binzhou Medical University, Yantai, 264000, Shandong, P. R. China 2. Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, 213000, Jiangsu, P. R. China
2. Department of Cardiology, Yantai Yuhuangding Hospital, Yantai, 264000, Shandong, P. R. China
3. Department of Radiology, Yantaishan Hospital Affiliated to Binzhou Medical University, Yantai, 264000, Shandong, P. R. China
4. Department of Thoracic Surgery, Yantaishan Hospital Affiliated to Binzhou Medical University, Yantai, 264000, Shandong, P. R. China
5. Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, 213000, Jiangsu, P. R. China
- Publication Type:Journal Article
- Keywords:
Artificial intelligence;
adenocarcinoma;
pulmonary nodules;
quantitative analysis;
pathological grading
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(05):598-607
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical value of artificial intelligence (AI) quantitative parameters in distinguishing pathological grades of stageⅠ invasive adenocarcinoma (IAC). Methods Clinical data of patients with clinical stageⅠ IAC admitted to Yantaishan Hospital Affiliated to Binzhou Medical University from October 2018 to May 2023 were retrospectively analyzed. Based on the 2021 WHO pathological grading criteria for lung adenocarcinoma, IAC was divided into gradeⅠ, grade Ⅱ, and grade Ⅲ. The differences in parameters among the groups were compared, and logistic regression analysis was used to evaluate the predictive efficacy of AI quantitative parameters for grade Ⅲ IAC patients. Parameters were screened using least absolute shrinkage and selection operator (LASSO) regression analysis. Three machine learning models were constructed based on these parameters to predict grade Ⅲ IAC and were internally validated to assess their efficacy. Nomograms were used for visualization. Results A total of 261 IAC patients were included, including 101 males and 160 females, with an average age of 27-88 (61.96±9.17) years. Six patients had dual primary lesions, and different lesions from the same patient were analyzed as independent samples. There were 48 patients of gradeⅠ IAC, 89 patients of grade Ⅱ IAC, and 130 patients of grade Ⅲ IAC. There were statitical differences in the AI quantitive parameters such as consolidation/tumor ratio (CTR), ect among the three goups. (P<0.05). Univariate analysis showed that the differences in all variables except age were statistically significant (P<0.05) between the group gradeⅠ+grade Ⅱand the group grade Ⅲ . Multivariate analysis suggested that CTR and CT standard deviation were independent risk factors for identifying grade Ⅲ IAC, and the two were negatively correlated. Grade Ⅲ IAC exhibited advanced TNM staging, more pathological high-risk factors, higher lymph node metastasis rate, and higher proportion of advanced structure. CTR was positively correlated with the proportion of advanced structures in all patients. This correlation was also observed in grade Ⅲ but not in gradeⅠand grade ⅡIAC. CTR and CT median value were selected by using LASSO regression. Logistic regression, random forest, and XGBoost models were constructed and validated, among which, the XGBoost model demonstrated the best predictive performance. Conclusion Cautious consideration should be given to grade Ⅲ IAC when CTR is higher than 39.48% and CT standard deviation is less than 122.75 HU. The XGBoost model based on combined CTR and CT median value has good predictive efficacy for grade Ⅲ IAC, aiding clinicians in making personalized clinical decisions.
