Accurate Diagnosis and Grading of Pediatric Solid Tumors Based on Pathological Large Models
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 1,229
- 试验地点
- 1
- 主要终点
- Diagnostic accuracy of patients
研究概览
简要总结
Pediatric malignancies are the second leading cause of death in the pediatric population, with solid tumors accounting for approximately 60% of all pediatric malignancies. The pathological diagnosis of pediatric solid tumors is highly complex and specialized, because of its diverse tissue morphology, rare tumor subtypes and lack of labeling data, the traditional pathological diagnosis relies on the experience of senior pathologists, but in actual clinical practice, due to the lack of expert resources and inconsistent diagnostic standards, more efficient and accurate auxiliary diagnostic tools are urgently needed. In this study, we aim to construct a multimodal dataset by collecting high-quality pathological images and pathological diagnosis results of pediatric solid tumors (neuroblastoma, medulloblastoma, Wilms tumor, hepatoblastoma, rhabdomyosarcoma, etc.), and introduce medical knowledge enhancement strategies on this basis, and improve the medical reasoning ability and adaptability to fine-grained pathological tasks by injecting domain knowledge (such as molecular characteristics of tumors, pathological grading standards, diagnostic rules, etc.) into the model. Through the model, the representation space of images and texts is unified, and diversified diagnostic tasks of pediatric solid tumors such as tumor region segmentation, cancer detection, and tumor subtype identification are realized, providing intelligent support for the accurate diagnosis and personalized treatment of pediatric solid tumors.
详细描述
Diagnosis test
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 0 Years 至 18 Years(Child, Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Neuroblastoma (NB): For newly diagnosed patients with NB aged 0-18 years, the diagnosis criteria are one of the following two items: (1) the patient's tumor tissue has obtained a positive pathological diagnosis under the light microscope; (2) Bone marrow biopsy or aspiration revealed characteristic neuroblastoma cells, which were small round cells, arranged in a nested or chrysanthemum clump or positive staining for anti-GD2 antibodies, and accompanied by an increase in urinary vanillylmandelic acid (VMA) and an increase in blood neuron-specific enolase (NSE).
- •Wilms tumor (nephroblastoma): patients aged 0-18 years old who have been diagnosed with Wilms tumor by histopathology.
- •Hepatoblastoma (HB): Patients aged 0-18 years who have been diagnosed with hepatoblastoma by histopathology.
- •Medulloblastoma (MB): Patients aged 0-18 years with a confirmed histopathological diagnosis of medulloblastoma.
- •rhabdomyosarcoma (RMS): patients aged 0-18 years old who have been diagnosed with medulloblastoma by histopathology.
排除标准
- •The patient's medical record and treatment follow-up information are incomplete; HE is not stained or faded
- •Those who have 2 or more types of tumors at the same time;
- •Those who do not meet the enrollment criteria.
- •Tumor subtype with less than 3 WSI images
结局指标
主要结局
Diagnostic accuracy of patients
时间窗: immediately after surgery
For the diagnostic model, we use both micro and macro area under the curve (AUC) metrics to evaluate the model in terms of sensitivity, specificity, accuracy, positive predictive value and negative predictive value at different classification thresholds
次要结局
未报告次要终点
研究者
Kun Sun
Professor of Department of Pediatric Cardiology
Xinhua Hospital, Shanghai Jiao Tong University School of Medicine
