A multimodality test to guide the management of patients with a pancreatic cyst.

Aged Algorithms Female Humans Machine Learning Male Middle Aged Pancreatic Cyst / diagnosis

Journal

Science translational medicine
ISSN: 1946-6242
Titre abrégé: Sci Transl Med
Pays: United States
ID NLM: 101505086

Informations de publication

Date de publication:
17 07 2019
Historique:
received: 21 09 2018
revised: 07 01 2019
accepted: 24 06 2019
entrez: 19 7 2019
pubmed: 19 7 2019
medline: 28 7 2020
Statut: ppublish

Résumé

Pancreatic cysts are common and often pose a management dilemma, because some cysts are precancerous, whereas others have little risk of developing into invasive cancers. We used supervised machine learning techniques to develop a comprehensive test, CompCyst, to guide the management of patients with pancreatic cysts. The test is based on selected clinical features, imaging characteristics, and cyst fluid genetic and biochemical markers. Using data from 436 patients with pancreatic cysts, we trained CompCyst to classify patients as those who required surgery, those who should be routinely monitored, and those who did not require further surveillance. We then tested CompCyst in an independent cohort of 426 patients, with histopathology used as the gold standard. We found that clinical management informed by the CompCyst test was more accurate than the management dictated by conventional clinical and imaging criteria alone. Application of the CompCyst test would have spared surgery in more than half of the patients who underwent unnecessary resection of their cysts. CompCyst therefore has the potential to reduce the patient morbidity and economic costs associated with current standard-of-care pancreatic cyst management practices.

Identifiants

DOI: 10.1126/scitranslmed.aav4772 PMID: 31316009 PMC: PMC7859881
pubmed: 31316009
pii: 11/501/eaav4772
doi: 10.1126/scitranslmed.aav4772
pmc: PMC7859881
mid: NIHMS1068904
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : NIGMS NIH HHS
ID : T32 GM136577
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA176828
Pays : United States
Organisme : NCI NIH HHS
ID : P50 CA062924
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA210170
Pays : United States

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

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Auteurs

Simeon Springer (S)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0002-2891-2111

David L Masica (DL)

Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Biomedical Engineering, Johns Hopkins Medical Institutions, Johns Hopkins University, Baltimore, MD 21287, USA.
Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.

Marco Dal Molin (M)

Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0003-1581-3576

Christopher Douville (C)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Biomedical Engineering, Johns Hopkins Medical Institutions, Johns Hopkins University, Baltimore, MD 21287, USA.
Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0002-2510-4151

Christopher J Thoburn (CJ)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0001-7743-9183

Bahman Afsari (B)

Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0001-8717-7199

Lu Li (L)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0002-1920-4965

Joshua D Cohen (JD)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Biomedical Engineering, Johns Hopkins Medical Institutions, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0003-1158-5668

Elizabeth Thompson (E)

Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0003-4633-843X

Peter J Allen (PJ)

Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.

David S Klimstra (DS)

Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.

Mark A Schattner (MA)

Department of Gastroenterology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.

C Max Schmidt (CM)

Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
ORCID: 0000-0003-2447-2128

Michele Yip-Schneider (M)

Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
ORCID: 0000-0001-7569-7971

Rachel E Simpson (RE)

Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA.

Carlos Fernandez-Del Castillo (C)

Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.

Mari Mino-Kenudson (M)

Department of Histopathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
ORCID: 0000-0002-9092-2265

William Brugge (W)

Department of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
ORCID: 0000-0001-9119-5170

Randall E Brand (RE)

Department of Medicine, University of Pittsburgh, Pittsburgh PA 15213, USA.
ORCID: 0000-0002-4136-3313

Aatur D Singhi (AD)

Department of Pathology, University of Pittsburgh, Pittsburgh, PA 15213, USA.

Aldo Scarpa (A)

ARC-Net Research Centre, University and Hospital Trust of Verona, Verona 37134, Italy.
Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona 37134, Italy.
ORCID: 0000-0003-1678-739X

Rita Lawlor (R)

ARC-Net Research Centre, University and Hospital Trust of Verona, Verona 37134, Italy.
Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona 37134, Italy.
ORCID: 0000-0003-3160-0634

Roberto Salvia (R)

General and Pancreatic Surgery, Pancreas Institute, University and Hospital Trust of Verona, Verona 37134, Italy.
ORCID: 0000-0002-3514-8473

Giuseppe Zamboni (G)

Department of Pathology, Ospedale Sacro Cuore-Don Calabria, Negrar 37024, Italy.
ORCID: 0000-0001-7428-4673

Seung-Mo Hong (SM)

Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea.
ORCID: 0000-0002-8888-6007

Dae Wook Hwang (DW)

Hepatobiliary and Pancreas Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea.
ORCID: 0000-0002-1749-038X

Jin-Young Jang (JY)

Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea.
ORCID: 0000-0003-3312-0503

Wooil Kwon (W)

Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea.
ORCID: 0000-0002-4827-7805

Niall Swan (N)

Department of Histopathology, St. Vincent's University Hospital, Dublin D04 T6F4, Ireland.
ORCID: 0000-0003-2838-6972

Justin Geoghegan (J)

Department of Surgery, St. Vincent's University Hospital, Dublin D04 T6F4, Ireland.
ORCID: 0000-0003-0266-3732

Massimo Falconi (M)

Division of Pancreatic Surgery, Department of Surgery, IRCCS San Raffaele Scientific Institute, Milan 20132, Italy.

Stefano Crippa (S)

Division of Pancreatic Surgery, Department of Surgery, IRCCS San Raffaele Scientific Institute, Milan 20132, Italy.

Claudio Doglioni (C)

Department of Pathology, IRCCS San Raffaele Scientific Institute, Milan 20132, Italy.
ORCID: 0000-0002-4969-5216

Jorge Paulino (J)

Department of Surgery, Centro Hepatobiliopancreático e Transplantação, Hospital Curry Cabral, Lisbon 1050-099, Portugal.
ORCID: 0000-0002-8491-2802

Richard D Schulick (RD)

Department of Surgery, University of Colorado, Aurora, CO 80045, USA.
ORCID: 0000-0001-7360-7338

Barish H Edil (BH)

Department of Surgery, University of Colorado, Aurora, CO 80045, USA.
ORCID: 0000-0003-1467-9723

Walter Park (W)

Department of Medicine, Stanford University Medical Center, Palo Alto, CA 94304, USA.

Shinichi Yachida (S)

Department of Hepatobiliary and Pancreatic Surgery, Pathology and Cancer Genomics, National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo 104-0045, Japan.

Susumu Hijioka (S)

Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan.
ORCID: 0000-0002-0394-6876

Jeanin van Hooft (J)

Department of Gastroenterology and Hepatology, Amsterdam Medical Center, Amsterdam 1017 ZX, Netherlands.

Jin He (J)

Department of Surgery, Johns Hopkins University, Baltimore, MD 21287, USA.

Matthew J Weiss (MJ)

Department of Surgery, Johns Hopkins University, Baltimore, MD 21287, USA.

Richard Burkhart (R)

Department of Surgery, Johns Hopkins University, Baltimore, MD 21287, USA.

Martin Makary (M)

Department of Surgery, Johns Hopkins University, Baltimore, MD 21287, USA.

Marcia I Canto (MI)

Department of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.

Michael G Goggins (MG)

Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0002-4286-2296

Janine Ptak (J)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0003-1934-8739

Lisa Dobbyn (L)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0002-3159-189X

Joy Schaefer (J)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0001-6788-8989

Natalie Sillman (N)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0002-5198-9037

Maria Popoli (M)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0003-2151-7749

Alison P Klein (AP)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0003-2737-8399

Cristian Tomasetti (C)

Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA. bertvog@gmail.com amlennon@jhmi.edu cwolfga2@jhmi.edu rhruban@jhmi.edu ctomasetti@jhu.edu karchin@jhu.edu.
Department of Biostatistics and Bioinformatics, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0003-3277-4804

Rachel Karchin (R)

Department of Biomedical Engineering, Johns Hopkins Medical Institutions, Johns Hopkins University, Baltimore, MD 21287, USA.
Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA. bertvog@gmail.com amlennon@jhmi.edu cwolfga2@jhmi.edu rhruban@jhmi.edu ctomasetti@jhu.edu karchin@jhu.edu.
ORCID: 0000-0002-5069-1239

Nickolas Papadopoulos (N)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0001-7135-7451

Kenneth W Kinzler (KW)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0001-5591-1176

Bert Vogelstein (B)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA. bertvog@gmail.com amlennon@jhmi.edu cwolfga2@jhmi.edu rhruban@jhmi.edu ctomasetti@jhu.edu karchin@jhu.edu.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0003-0766-3854

Christopher L Wolfgang (CL)

Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA. bertvog@gmail.com amlennon@jhmi.edu cwolfga2@jhmi.edu rhruban@jhmi.edu ctomasetti@jhu.edu karchin@jhu.edu.
Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Surgery, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0002-8717-0373

Ralph H Hruban (RH)

Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA.
Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA. bertvog@gmail.com amlennon@jhmi.edu cwolfga2@jhmi.edu rhruban@jhmi.edu ctomasetti@jhu.edu karchin@jhu.edu.
ORCID: 0000-0003-4554-5672

Anne Marie Lennon (AM)

Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD 21287, USA. bertvog@gmail.com amlennon@jhmi.edu cwolfga2@jhmi.edu rhruban@jhmi.edu ctomasetti@jhu.edu karchin@jhu.edu.
Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Surgery, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
Department of Radiology, Johns Hopkins University, Baltimore, MD 21287, USA.
ORCID: 0000-0001-8957-3945

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › A multimodality test to guide the management...
questionsmedicales.fr › Sciences de l'information › Méthodologies informatiques › Algorithmes › A multimodality test to guide the management...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › A multimodality test to guide the management...
questionsmedicales.fr › Sciences de l'information › Méthodologies informatiques › Algorithmes › Intelligence artificielle › Apprentissage machine › A multimodality test to guide the management...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › A multimodality test to guide the management...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du pancréas › Kyste du pancréas › A multimodality test to guide the management...