A multimodality test to guide the management of patients with a pancreatic cyst.
A multimodality test to guide the management of patients with a pancreatic cyst.
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一种多模式测试，可指导胰腺囊肿患者的管理。
DOI：
10.1126/scitranslmed.aav4772
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发表时间：
2019-07-17
影响因子：
17.1
通讯作者：
Lennon AM
中科院分区：
文献类型：
--
作者：
Springer S;Masica DL;Dal Molin M;Douville C;Thoburn CJ;Afsari B;Li L;Cohen JD;Thompson E;Allen PJ;Klimstra DS;Schattner MA;Schmidt CM;Yip-Schneider M;Simpson RE;Fernandez-Del Castillo C;Mino-Kenudson M;Brugge W;Brand RE;Singhi AD;Scarpa A;Lawlor R;Salvia R;Zamboni G;Hong SM;Hwang DW;Jang JY;Kwon W;Swan N;Geoghegan J;Falconi M;Crippa S;Doglioni C;Paulino J;Schulick RD;Edil BH;Park W;Yachida S;Hijioka S;van Hooft J;He J;Weiss MJ;Burkhart R;Makary M;Canto MI;Goggins MG;Ptak J;Dobbyn L;Schaefer J;Sillman N;Popoli M;Klein AP;Tomasetti C;Karchin R;Papadopoulos N;Kinzler KW;Vogelstein B;Wolfgang CL;Hruban RH;Lennon AM
胰腺囊肿是常见的，往往造成管理困境，因为有些囊肿是癌前病变，而其他人几乎没有发展成浸润性癌症的风险。我们使用监督机器学习技术开发了一种综合测试CompCyst，以指导胰腺囊肿患者的管理。该测试是基于选定的临床特征，影像学特征，以及囊液遗传和生化标志物。使用来自436例胰腺囊肿患者的数据，我们训练CompCyst将患者分类为需要手术的患者，需要常规监测的患者和不需要进一步监测的患者。然后，我们在一个由426名患者组成的独立队列中测试了CompCyst，并以组织病理学作为金标准。我们发现，由CompCyst测试告知的临床管理比仅由常规临床和成像标准指示的管理更准确。CompCyst测试的应用将使超过一半的接受不必要囊肿切除术的患者免于手术。因此，CompCyst有可能降低与当前标准治疗胰腺囊肿管理实践相关的患者发病率和经济成本。
Pancreatic cysts are common and often pose a management dilemma, because some cysts are precancerous, whereas others have little risk of developing into invasive cancers. We used supervised machine learning techniques to develop a comprehensive test, CompCyst, to guide the management of patients with pancreatic cysts. The test is based on selected clinical features, imaging characteristics, and cyst fluid genetic and biochemical markers. Using data from 436 patients with pancreatic cysts, we trained CompCyst to classify patients as those who required surgery, those who should be routinely monitored, and those who did not require further surveillance. We then tested CompCyst in an independent cohort of 426 patients, with histopathology used as the gold standard. We found that clinical management informed by the CompCyst test was more accurate than the management dictated by conventional clinical and imaging criteria alone. Application of the CompCyst test would have spared surgery in more than half of the patients who underwent unnecessary resection of their cysts. CompCyst therefore has the potential to reduce the patient morbidity and economic costs associated with current standard-of-care pancreatic cyst management practices.
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影响因子：
24.5
作者：
European Study Group on Cystic Tumours of the Pancreas
通讯作者：
European Study Group on Cystic Tumours of the Pancreas
DOI：
10.2214/ajr.07.3340
发表时间：
2008-09
期刊：
AJR. American journal of roentgenology
影响因子：
--
作者：
Laffan TA;Horton KM;Klein AP;Berlanstein B;Siegelman SS;Kawamoto S;Johnson PT;Fishman EK;Hruban RH
通讯作者：
Hruban RH
影响因子：
9.6
作者：
de Wilde, R. F.;Besselink, M. G. H.;Molenaar, I. Q.
通讯作者：
Molenaar, I. Q.
DOI：
10.1093/jamia/ocw069
发表时间：
2017-01-01
影响因子：
6.4
作者：
Masica, David L.;Dal Molin, Marco;Lennon, Anne Marie
通讯作者：
Lennon, Anne Marie
DOI：
10.1097/pas.0000000000000533
发表时间：
2015-12
期刊：
The American journal of surgical pathology
影响因子：
--
作者：
Basturk O;Hong SM;Wood LD;Adsay NV;Albores-Saavedra J;Biankin AV;Brosens LA;Fukushima N;Goggins M;Hruban RH;Kato Y;Klimstra DS;Klöppel G;Krasinskas A;Longnecker DS;Matthaei H;Offerhaus GJ;Shimizu M;Takaori K;Terris B;Yachida S;Esposito I;Furukawa T;Baltimore Consensus Meeting
通讯作者：
Baltimore Consensus Meeting