Machine Learning Models for the Diagnosis and Prognosis Prediction of High-Grade B-Cell Lymphoma.
Machine Learning Models for the Diagnosis and Prognosis Prediction of High-Grade B-Cell Lymphoma.
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用于高级别 B 细胞淋巴瘤诊断和预后预测的机器学习模型
DOI：
10.3389/fimmu.2022.919012
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发表时间：
2022
影响因子：
7.3
通讯作者：
中科院分区：
文献类型：
--
作者：
高级别b细胞淋巴瘤（HGBL）是一种罕见的异质侵袭性b细胞淋巴瘤（BCL）的新类别，其诊断依赖于荧光原位杂交（FISH），这是一种昂贵且费力的分析。为了用最少的检查和费用来识别HGBL， 187名新诊断的BCL患者被纳入了一项队列研究。因此，HGBL组的总生存期（OS）和无进展生存期（PFS）低于非HGBL组。HGBL （n = 35）更有可能具有高级别组织形态学外观，结外受累，骨髓受累和全身最大标准化摄取（SUVmax）。机器学习分类模型显示，组织形态学外观、Ann Arbor分期、乳酸脱氢酶（LDH）、国际预后指数（IPI）危险组是诊断HGBL的独立危险因素。高IPI风险组的患者，CD10阳性，结外累及、高LDH、高白细胞（WBC）、骨髓累及、老年、安娜堡晚期和高SUVmax的患者在1年内死亡的风险较高。此外，这些模型提示患者应建议进行FISH检查的临床特征。此外，本研究支持一线治疗R-CHOP对HGBL的疗效不佳。目前迫切需要一种新的诱导治疗方案来改善HGBL患者的不良预后。
High-grade B-cell lymphoma (HGBL) is a newly introduced category of rare and heterogeneous invasive B-cell lymphoma (BCL), which is diagnosed depending on fluorescence in situ hybridization (FISH), an expensive and laborious analysis. In order to identify HGBL with minimal workup and costs, a total of 187 newly diagnosed BCL patients were enrolled in a cohort study. As a result, the overall survival (OS) and progression-free survival (PFS) of the HGBL group were inferior to those of the non-HGBL group. HGBL (n = 35) was more likely to have a high-grade histomorphology appearance, extranodal involvement, bone marrow involvement, and whole-body maximum standardized uptake (SUVmax). The machine learning classification models indicated that histomorphology appearance, Ann Arbor stage, lactate dehydrogenase (LDH), and International Prognostic Index (IPI) risk group were independent risk factors for diagnosing HGBL. Patients in the high IPI risk group, who are CD10 positive, and who have extranodal involvement, high LDH, high white blood cell (WBC), bone marrow involvement, old age, advanced Ann Arbor stage, and high SUVmax had a higher risk of death within 1 year. In addition, these models prompt the clinical features with which the patients should be recommended to undergo a FISH test. Furthermore, this study supports that first-line treatment with R-CHOP has dismal efficacy in HGBL. A novel induction therapeutic regimen is still urgently needed to ameliorate the poor outcome of HGBL patients.
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影响因子：
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