肝癌分级App的开发和临床应用研究

Design and Clinical Validation of a Mobile Application for Hepatocellular Carcinoma Barcelona Clinic Liver Cancer Staging System

目的:设计开发一款临床医生进行原发性肝癌(Hepatocellular carcinoma,HCC)巴塞罗那分级(Barcelona clinic liver cancer staging,BCLC)移动应用程序(App),以辅助临床医生正确对患者分级、选择治疗策略以及评估预后。方法:使用美国癌症影像数据库(The Cancer Imaging Archive,TGIA)中的HCC癌症基因组图谱(TCGA-LIHC)中18名患者资料进行临床测试。招募不同科室的8名住院医师,随机抽取9个病例以自由书写形式分级,其余9个病例使用App进行分级,以两名高年资医生结论作为评判标准。采用非参数检验分析两组测试结果的准确性,随后调查医生对App满意度。结果:共144份测试结果纳入研究,使用App进行分级结果准确性优于未使用App组(整体准确性得分:80.21±15.38vs 75.52±15.62,P=0.04),差异具有统计学意义。使用者对该App满意度较高,同时提出了改进建议。结论:BCLC分级App便于临床医生对HCC患者进行分级,提高了分级的准确性,有推广价值。

Objective： In order to assist clinical doctor correctly stage and select treatment strategy as well as evaluating prognosis of hepatocellular carcinoma （HCC） patients according to Barcelona chnic liver cancer staging system （BCLC）, we developed a mobile application （App）. Methods： We used 18 patients＇ data from the Cancer Genome Atlas Liver Hepatocellular Carcinoma （TCGA- LIHC） from the American Cancer hnaging Archive （TGIA） database to test the App. We selected 8 resident doctors from. different departments to randomly choose 9 cases to stage by free text, while the other cases staged by App. We used answers from 2 senior physicians as criteria. The two sets of test results were analyzed by non-parametric test and we investigated the doctor＇s satisfaction with APP user interface. Results： We collected 144 results. The stage results from the App had significant difference in comparison with free text （accuracy score, 80.21±15.38 vs 75.52±15.62, P=0.04）. The users had relatively high satisfaction with the App. Conclusion： It is convenient for clinical doctors to stage HCC patients with BCLC staging App, and the App improved the accuracy of staging, thus had practical value.