Application of Machine Learning Algorithms to Predict Lymph Node Metastasis in Early Gastric Cancer

HuaKai Tian; ZhiKun Ning; Zhen Zong; Jiang Liu; CeGui Hu; HouQun Ying; Hui Li

doi:10.3389/fmed.2021.759013

Application of Machine Learning Algorithms to Predict Lymph Node Metastasis in Early Gastric Cancer

Front Med (Lausanne). 2022 Jan 18:8:759013. doi: 10.3389/fmed.2021.759013. eCollection 2021.

Authors

HuaKai Tian^{1

2}, ZhiKun Ning³, Zhen Zong², Jiang Liu², CeGui Hu², HouQun Ying⁴, Hui Li⁵

Affiliations

¹ Department of General Surgery, First Affiliated Hospital of Nanchang University, Nanchang, China.
² Department of Gastrointestinal Surgery, Second Affiliated Hospital of Nanchang University, Nanchang, China.
³ Department of Day Ward, First Affiliated Hospital of Nanchang University, Nanchang, China.
⁴ Department of Nuclear Medicine, Jiangxi Province Key Laboratory of Laboratory Medicine, Second Affiliated Hospital of Nanchang University, Nanchang, China.
⁵ Department of Rheumatology and Immunology, First Affiliated Hospital of Nanchang University, Nanchang, China.

Abstract

Objective: This study aimed to establish the best early gastric cancer lymph node metastasis (LNM) prediction model through machine learning (ML) to better guide clinical diagnosis and treatment decisions.

Methods: We screened gastric cancer patients with T1a and T1b stages from 2010 to 2015 in the Surveillance, Epidemiology and End Results (SEER) database and collected the clinicopathological data of patients with early gastric cancer who were treated with surgery at the Second Affiliated Hospital of Nanchang University from January 2014 to December 2016. At the same time, we applied 7 ML algorithms-the generalized linear model (GLM), RPART, random forest (RF), gradient boosting machine (GBM), support vector machine (SVM), regularized dual averaging (RDA), and the neural network (NNET)-and combined them with patient pathological information to develop the best prediction model for early gastric cancer lymph node metastasis. Among the SEER set, 80% were randomly selected to train the models, while the remaining 20% were used for testing. The data from the Second Affiliated Hospital were considered as the external verification set. Finally, we used the AUROC, F1-score value, sensitivity, and specificity to evaluate the performance of the model.

Results: The tumour size, tumour grade, and depth of tumour invasion were independent risk factors for early gastric cancer LNM. Comprehensive comparison of the prediction model performance of the training set and test set showed that the RDA model had the best prediction performance (F1-score = 0.773; AUROC = 0.742). The AUROC of the external validation set was 0.73.

Conclusions: Tumour size, tumour grade, and depth of tumour invasion were independent risk factors for early gastric cancer LNM. ML predicted LNM risk more accurately, and the RDA model had the best predictive performance and could better guide clinical diagnosis and treatment decisions.

Keywords: early gastric cancer; lymph node metastasis; machine learning; predictive model; regularized dual averaging (RDA).