人工智能在胰腺癌诊治中的应用现状

马昱; 贾峰; 刘楷宇; 刘亚辉

doi:10.12449/JCH241032

人工智能在胰腺癌诊治中的应用现状

DOI: 10.12449/JCH241032

吉林大学第一医院普通外科中心肝胆胰外二科，长春 130000

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：马昱负责设计论文框架，起草论文；贾峰负责关键点分析，论文修改；马昱、刘楷宇负责文献查找；刘亚辉负责拟定写作思路，指导撰写文章并最后定稿。

详细信息

通信作者:
刘亚辉， yahui@jlu.edu.cn （ORCID： 0000-0002-5431-1440）

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出版历程
- 收稿日期: 2023-12-28
- 录用日期: 2024-03-20
- 出版日期: 2024-10-25

Current status of the application of artificial intelligence in the diagnosis and treatment of pancreatic cancer

Second Department of Hepatopancreatobiliary Surgery，General Surgery Center，The First Hospital of Jilin University，Changchun 130000，China

More Information

Corresponding author: LIU Yahui， yahui@jlu.edu.cn （ORCID： 0000-0002-5431-1440）

摘要

摘要: 胰腺癌是消化系统常见的恶性肿瘤，早期诊断率低，手术病死率高，治愈率低，总体预后差。近年来，随着人工智能在医学领域的不断发展，机器学习、深度学习等人工智能技术被广泛应用于医学研究中。本文综述了近年来人工智能技术在胰腺癌筛查、诊断、治疗、并发症及预后预测等方面的应用，为人工智能在胰腺癌诊治中的应用提供依据和新思路。
- 人工智能 /
- 胰腺肿瘤 /
- 机器学习 /
- 深度学习
Abstract: Pancreatic cancer is a common malignant tumor of the digestive system， with a low early diagnosis rate， a high surgical mortality rate， a low cure rate， and a poor overall prognosis. In recent years， with the continuous development of artificial intelligence in the medical field， artificial intelligence techniques， such as machine learning and deep learning， have been widely used in medical research. This article reviews the application of artificial intelligence techniques in the screening， diagnosis， treatment， complications， and prognosis prediction of pancreatic cancer， so as to provide a basis and new ideas for the application of artificial intelligence in the diagnosis and treatment of pancreatic cancer.
- Artificial Intelligence /
- Pancreatic Neoplasms /
- Machine Learning /
- Deep Learning

HTML全文

抗病毒治疗是慢性乙型肝炎(CHB)的关键措施，其中恩替卡韦(ETV) 是治疗HBV的一线核苷(酸)类似物(NAs) 之一。尽管其他研究曾报道了长期ETV治疗CHB的疗效和安全性，但其在中国慢性CHB(主要为基因型B和C)患者中的临床数据仍然有限。

马来酸ETV是正大天晴药业股份有限公司开发的ETV衍生物，多中心、随机、双盲双模拟、阳性药物对照临床研究显示其治疗48周时与原研ETV在治疗CHB时等效，基于上述结果，国家食品药品管理局已经批准其上市。作为此项研究的主要研究者，北京大学第一医院于岩岩教授对其长期疗效和安全性进行了进一步研究：此前已经报告144周的马来酸ETV治疗中国慢性CHB(主要为基因型B和C)患者有效而且安全。更长疗程的药物治疗效果和安全性如何，尚无知晓。

2022年7月6日于岩岩教授团队在线发表研究论文，旨在更新马来酸ETV治疗中国患者240周疗程的病毒学、血清学和生化结果。CHB受试者被随机分配接受0.5 mg/d ETV(A组)或0.5 mg/d马来酸ETV(B组)治疗48周，此后所有受试者从第49周开始接受0.5 mg/d马来酸ETV治疗。定期对患者进行随访，监测血清HBV标志物、肝生化等指标，记录不良事件(AE)。主要终点是治疗结束时每组HBV DNA的下降。次要终点包括治疗结束时HBV DNA不可测(＜20 IU/mL) 的比率、HBeAg消失率、HBeAg血清转化率和血清ALT复常率。137例(A组71例) HBeAg阳性CHB患者和46例(A组21例)HBeAg阴性CHB患者完成了240周的治疗和随访。两组的基线特征可比。在HBeAg阳性CHB组，240周时两组的HBV DNA较基线下降平均值可比(A：6.67 log₁₀ IU/mL vs B：6.74 log₁₀ IU/mL；P＞0.05)，血清HBV DNA不可测率(A：91.55% vs B：87.88%；P＞0.05)、HBeAg血清学转换率(A：26.98% vs B：20.97%；P＞0.05)和ALT复常率(A：87.32% vs B：83.61%；P＞0.05)均在组间可比。在HBeAg阴性CHB组，240周时两组的HBV DNA较基线下降平均值可比(A：6.05 log₁₀ IU/mL vs B：6.10 log₁₀ IU/mL；P＞0.05)，血清HBV DNA不可测比例(A：100% vs B：100%)和ALT复常率(A：90.91% vs B：95.45%)(P＞0.05)也可比。在耐药方面，HBeAg阴性CHB组耐药率为0；HBeAg阳性CHB组144周时耐药率1.16%，此后直至240周新增1例ETV耐药。安全性方面，没有因为AE导致停药，无肝癌或死亡病例。

总之，作为国产抗HBV药物代表之一的马来酸ETV，长期治疗中国CHB(主要是基因型B或C)是安全有效的。

摘译自XU JH, FAN YN, YU YY, et al. 240-week entecavir maleate treatment in Chinese chronic hepatitis B predominantly genotype B or C[J]. J Viral Hepat, 2022, 29(10): 862-867. DOI: 10.1111/jvh.13724.

(北京大学第一医院感染疾病科徐京杭报道)

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