人工智能技术在当前生物学获益为主的胰腺癌诊疗模式中的发展方向

doi:10.16139/j.1007-9610.2024.01.02

摘要/Abstract

摘要：

胰腺癌恶性程度高，发病隐匿，早期转移，预后极差。如何提高早期诊断率、改善病人预后是目前研究焦点。当前传统手术治疗虽可能一定程度上改善部分病人预后，但远期疗效仍较差。生物学获益是当前胰腺癌治疗的新模式，此模式下做好全过程监测、精准制定治疗方案及预测疗效至关重要。人工智能技术因其强大的数据处理、图像识别功能，较高的学习效率，在多学科专家通力合作下可建立相对完美的预测模型，协助临床医师制定优化方案，采用精准医疗模式及个体化治疗方案，使胰腺癌病人获益。

关键词: 人工智能, 生物学获益, 胰腺癌, 诊断, 治疗

Abstract:

Pancreatic cancer is a high malignant tumor with insidious onset, early metastasis, and extremely poor prognosis. How to improve the early diagnosis and the prognosis of the patients is the current research focus. Although traditional surgical resection may improve the prognosis of some patients, the long-term effect is still poor. Biological benefit is the new mode of pancreatic cancer treatment, and it is crucial to do the whole process monitoring, precisely make the treatment plan and predict the effect under this mode. Artificial intelligence technology, with its powerful data processing and image recognition functions and high learning efficiency, can help to build relatively perfect prediction models with the cooperation of multidisciplinary experts, assist clinicians to make optimal plans, and make the pancreatic cancer patients benefit from precision medicine and individualized therapy.

Key words: Artificial intelligence, Biological benefit, Pancreatic cancer, Diagnosis, Treatment

中图分类号:

R735.9

齐中, 邢颖, 程石. 人工智能技术在当前生物学获益为主的胰腺癌诊疗模式中的发展方向[J]. 外科理论与实践, 2024, 29(01): 5-9.

QI Zhong, XING Ying, CHENG Shi. The future directions of artificial intelligence in the biological benefit-dominated diagnosis and treatment of pancreatic cancer[J]. Journal of Surgery Concepts & Practice, 2024, 29(01): 5-9.

参考文献 30

[1]	SIEGEL R L, MILLER K D, FUCHS H E, et al. Cancer statistics, 2022[J]. CA Cancer J Clin, 2022, 72(1):7-33.
[2]	XIA C, DONG X, LI H, et al. Cancer statistics in China and United States, 2022: profiles, trends, and determinants[J]. Chin Med J (Engl), 2022, 135(5):584-590.
[3]	PARK W, CHAWLA A, O'REILLY E M. Pancreatic cancer: a review[J]. JAMA, 2021, 326(9):851-862. doi: 10.1001/jama.2021.13027 pmid: 34547082
[4]	SABA H, GOGGINS M. Familial pancreatic cancer[J]. Gastroenterol Clin North Am, 2022, 51(3):561-575.
[5]	KOYANAGI Y N, ITO H, MATSUO K, et al. Smoking and pancreatic cancer incidence: a pooled analysis of 10 population-based cohort studies in Japan[J]. Cancer Epidemiol Biomarkers Prev, 2019, 28(8):1370-1378.
[6]	GRAM I T, PARK S Y, WILKENS L R, et al. Smoking and pancreatic cancer: a sex-specific analysis in the multiethnic cohort study[J]. Cancer Causes Control, 2023, 34(1):89-100.
[7]	HU Y, ZHANG X, MA Y, et al. Incident type 2 diabetes duration and cancer risk: a prospective study in two US cohorts[J]. J Natl Cancer Inst, 2021, 113(4):381-389.
[8]	PETROV M S. Diabetes of the exocrine pancreas: American Diabetes Association-compliant lexicon[J]. Pancreatology, 2017, 17(4):523-526. doi: S1424-3903(17)30504-5 pmid: 28655595
[9]	CHO J, SCRAGG R, PETROV M S. Postpancreatitis diabetes confers higher risk for pancreatic cancer than type 2 diabetes: results from a nationwide cancer registry[J]. Diabetes Care, 2020, 43(9):2106-2112. doi: 10.2337/dc20-0207 pmid: 32616613
[10]	SREEDHAR U L, DESOUZA S V, PARK B, et al. A systematic review of intra-pancreatic fat deposition and pancreatic carcinogenesis[J]. J Gastrointest Surg, 2020, 24(11):2560-2569.
[11]	LIPP M, TARJÁN D, LEE J, et al. Fatty pancreas is a risk factor for pancreatic cancer: a systematic review and meta-analysis of 2956 patients[J]. Cancers (Basel), 2023, 15(19):4876.
[12]	STUART C E, KO J, MODESTO A E, et al. Implications of tobacco smoking and alcohol consumption on ectopic fat deposition in individuals after pancreatitis[J]. Pancreas, 2020, 49(7):924-934.
[13]	KLEIN A P. Pancreatic cancer epidemiology: understanding the role of lifestyle and inherited risk factors[J]. Nat Rev Gastroenterol Hepatol, 2021, 18(7):493-502. doi: 10.1038/s41575-021-00457-x pmid: 34002083
[14]	GOGGINS M, OVERBEEK K A, BRAND R, et al. International Cancer of the Pancreas Screening (CAPS) consortium. Management of patients with increased risk for familial pancreatic cancer: updated recommendations from the International Cancer of the Pancreas Screening (CAPS) consortium[J]. Gut, 2020, 69(1):7-17. doi: 10.1136/gutjnl-2019-319352 pmid: 31672839
[15]	OVERBEEK K A, GOGGINS M G, DBOUK M, et al. International cancer of the pancreas screening consortium. Timeline of development of pancreatic cancer and implications for successful early detection in high-risk individuals[J]. Gastroenterology, 2022, 162(3):772-785.
[16]	JAN Z, EL ASSADI F, ABD-ALRAZAQ A, et al. Artificial intelligence for the prediction and early diagnosis of pancreatic cancer: scoping review[J]. J Med Internet Res, 2023,25:e44248.
[17]	CHEN Q, CHERRY D R, NALAWADE V, et al. Clinical data prediction model to identify patients with early-stage pancreatic cancer[J]. JCO Clin Cancer Inform, 2021,5:279-287.
[18]	RIGIROLI F, HOYE J, LEREBOURS R, et al. CT radiomic features of superior mesenteric artery involvement in pancreatic ductal adenocarcinoma: a pilot study[J]. Radiology, 2021, 301(3):610-622.
[19]	CHEN F, ZHOU Y, QI X, et al. Radiomics-assisted presurgical prediction for surgical portal vein-superior mesenteric vein invasion in pancreatic ductal adenocarcinoma[J]. Front Oncol, 2020,10:523543.
[20]	BIAN Y, ZHENG Z, FANG X, et al. Artificial intelligence to predict lymph node metastasis at CT in pancreatic ductal adenocarcinoma[J]. Radiology, 2023, 306(1):160-169.
[21]	AN C, LI D, LI S, et al. Deep learning radiomics of dual-energy computed tomography for predicting lymph node metastases of pancreatic ductal adenocarcinoma[J]. Eur J Nucl Med Mol Imaging, 2022, 49(4):1187-1199.
[22]	MIYAMOTO R, OSHIRO Y, NAKAYAMA K, et al. Three-dimensional simulation of pancreatic surgery showing the size and location of the main pancreatic duct[J]. Surg Today, 2017, 47(3):357-364. doi: 10.1007/s00595-016-1377-6 pmid: 27368278
[23]	项楠, 杨剑, 张鹏, 等. 增强现实导航三维腹腔镜胰十二指肠切除术[J]. 中华外科杂志, 2020, 58(12):959-962.
	XIANG N, YANG J, ZHANG P, et al. Enhanced reality navigation for three-dimensional laparoscopic pancreaticoduodenectomy[J]. Chin J Surg, 2020, 58(12):959-962.
[24]	VERSTEIJNE E, SUKER M, GROOTHUIS K, et al. Preoperative chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer: results of the dutch randomized phase Ⅲ PREOPANC trial[J]. J Clin Oncol, 2020, 38(16):1763-1773.
[25]	BEKAII-SAAB T S, YAEGER R, SPIRA A I, et al. Adagrasib in advanced solid tumors harboring a KRAS^G12C mutation[J]. J Clin Oncol, 2023, 41(25):4097-4106.
[26]	COHEN J D, JAVED A A, THOBURN C, et al. Combined circulating tumor DNA and protein biomarker-based liquid biopsy for the earlier detection of pancreatic cancers[J]. Proc Natl Acad Sci U S A, 2017, 114(38):10202-10207.
[27]	SUGIMORI M, SUGIMORI K, TSUCHIYA H, et al. Quantitative monitoring of circulating tumor DNA in patients with advanced pancreatic cancer undergoing chemotherapy[J]. Cancer Sci, 2020, 111(1):266-278.
[28]	TOLEDANO-FONSECA M, CANO M T, INGA E, et al. Circulating cell-free DNA-based liquid biopsy markers for the non-invasive prognosis and monitoring of metastatic pancreatic cancer[J]. Cancers (Basel), 2020, 12(7):1754.
[29]	ANKENY J S, COURT C M, HOU S, et al. Circulating tumour cells as a biomarker for diagnosis and staging in pancreatic cancer[J]. Br J Cancer, 2016, 114(12):1367-1375.
[30]	PARK Y, JUN H R, CHOI H W, et al. Circulating tumour cells as an indicator of early and systemic recurrence after surgical resection in pancreatic ductal adenocarcinoma[J]. Sci Rep, 2021, 11(1):1644. doi: 10.1038/s41598-020-80383-1 pmid: 33462311