乳腺癌转移对全球女性健康影响显著。本研究旨在利用临床血液标志物和超声数据构建预测模型来预测乳腺癌患者的远处转移。确保临床适用性,成本效益,相对非侵入性,以及这些模型的可访问性。对来自两个中心的416名患者的数据进行了分析,专注于临床血液标志物(肿瘤标志物,肝肾功能指标,血脂标志物,心血管生物标志物)和超声检查的最大病变直径。使用Spearman相关和LASSO回归进行特征还原。使用LightGBM建立了两个模型:临床模型(使用临床血液标志物)和组合模型(结合临床血液标志物和超声特征),在培训中验证,内部测试,和外部验证(test1)队列。对这两个模型都进行了特征重要性分析,然后对这些特征进行单因素和多元回归分析。训练中临床模型的AUC值,内部测试,和外部验证(测试1)队列分别为0.950,0.795和0.883.组合模型在训练中的AUC值分别为0.955、0.835和0.918,内部测试,和外部验证(test1)队列,分别。临床效用曲线分析表明,在所有队列中,组合模型在识别具有远处转移的乳腺癌方面具有优越的净收益。这表明组合模型具有优越的判别能力和较强的泛化性能。肌酸激酶同工酶(CK-MB),CEA,CA153,白蛋白,肌酸激酶,超声的最大病变直径在模型预测中起着重要作用。CA153,CK-MB,脂蛋白(a),超声最大病灶直径与乳腺癌远处转移呈正相关,间接胆红素与镁离子呈负相关。这项研究成功地利用临床血液标志物和超声数据来开发AI模型来预测乳腺癌的远处转移。组合模型,结合临床血液标志物和超声特征,表现出更高的准确性,提示其在预测和识别乳腺癌远处转移方面的潜在临床应用。这些发现凸显了在临床肿瘤学中开发具有成本效益且易于使用的预测工具的潜在前景。
Breast cancer metastasis significantly impacts women\'s health globally. This study aimed to construct predictive models using clinical blood markers and ultrasound data to predict distant metastasis in breast cancer patients, ensuring clinical applicability, cost-effectiveness, relative non-invasiveness, and accessibility of these models. Analysis was conducted on data from 416 patients across two centers, focusing on clinical blood markers (tumor markers, liver and kidney function indicators, blood lipid markers, cardiovascular biomarkers) and maximum lesion diameter from ultrasound. Feature reduction was performed using Spearman correlation and LASSO regression. Two models were built using LightGBM: a clinical model (using clinical blood markers) and a combined model (incorporating clinical blood markers and ultrasound features), validated in training, internal test, and external validation (test1) cohorts. Feature importance analysis was conducted for both models, followed by univariate and multivariate regression analyses of these features. The AUC values of the clinical model in the training, internal test, and external validation (test1) cohorts were 0.950, 0.795, and 0.883, respectively. The combined model showed AUC values of 0.955, 0.835, and 0.918 in the training, internal test, and external validation (test1) cohorts, respectively. Clinical utility curve analysis indicated the combined model\'s superior net benefit in identifying breast cancer with distant metastasis across all cohorts. This suggests the combined model\'s superior discriminatory ability and strong generalization performance. Creatine kinase isoenzyme (CK-MB), CEA, CA153, albumin, creatine kinase, and maximum lesion diameter from ultrasound played significant roles in model prediction. CA153, CK-MB, lipoprotein (a), and maximum lesion diameter from ultrasound positively correlated with breast cancer distant metastasis, while indirect bilirubin and magnesium ions showed negative correlations. This study successfully utilized clinical blood markers and ultrasound data to develop AI models for predicting distant metastasis in breast cancer. The combined model, incorporating clinical blood markers and ultrasound features, exhibited higher accuracy, suggesting its potential clinical utility in predicting and identifying breast cancer distant metastasis. These findings highlight the potential prospects of developing cost-effective and accessible predictive tools in clinical oncology.