Improvements to the gastric cancer tumor-node-metastasis staging system based on computer-aided unsupervised clustering.
Improvements to the gastric cancer tumor-node-metastasis staging system based on computer-aided unsupervised clustering.
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基于计算机辅助无监督聚类的胃癌肿瘤-淋巴结-转移分期系统的改进
DOI：
10.1186/s12885-018-4623-z
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发表时间：
2018-07-03
期刊：
影响因子：
3.8
通讯作者：
Liu C
中科院分区：
文献类型：
--
作者：
Wang Z;Li M;Xu Z;Jiang Y;Gu H;Yu Y;Zhu H;Zhang H;Lu P;Xin J;Xu H;Liu C
国际癌症控制联盟（UICC）肿瘤-淋巴结-转移（TNM）分类是胃癌预后的关键系统。本研究旨在建立一个新的TNM系统，为胃癌的临床诊断和治疗提供参考。方法回顾性分析中国医科大学第一医院和辽宁省肿瘤医院胃癌患者的临床资料。基于患者预后数据，对所有可能的TNM分期情况进行计算机辅助无监督聚类，建立新的分期划分系统。结果主要观察指标为5年生存率，根据TNM分类进行分析。对所有TNM分期情况使用计算机辅助无监督聚类来创建更符合临床情况的TNM划分标准。此外，对N期淋巴结转移数量的无监督聚类导致了不同于现有N期标准的分类方法的制定，肿瘤大小的无监督聚类为预后估计提供了额外的参考。最后，我们开发了一个基于计算机辅助无监督聚类方法的TNM分期系统；与第7版UICC胃癌TNM分类相比，该系统更符合临床预后数据。
BackgroundThe Union for International Cancer Control (UICC) tumor-node-metastasis (TNM) classification is a key gastric cancer prognosis system. This study aimed to create a new TNM system to provide a reference for the clinical diagnosis and treatment of gastric cancer.MethodsA review of gastric cancer patients’ records was conducted in The First Hospital of China Medical University and the Liaoning Cancer Hospital and Institute. Based on patients’ prognoses data, computer-aided unsupervised clustering was performed for all possible TNM staging situations to create a new staging division system.ResultsThe primary outcome measure was 5-year survival, analyzed according to TNM classifications. Computer-aided unsupervised clustering for all TNM staging situations was used to create TNM division criteria that were more consistent with clinical situations. Furthermore, unsupervised clustering for the number of lymph node metastasis in the N stage led to the formulation of a classification method that differs from the existing N stage criteria, and unsupervised clustering for tumor size provided an additional reference for prognosis estimates.ConclusionsFinally, we developed a TNM staging system based on the computer-aided unsupervised clustering method; this system was more in line with clinical prognosis data when compared with the 7th edition of UICC gastric cancer TNM classification.
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