Development of a tongue image-based machine learning tool for the diagnosis of gastric cancer: a prospective multicentre clinical cohort study

作者：Yuan Li, Lin Yang, Shichuan Zhang, Zhiyuan Xu, Jiang‐Jiang Qin, Yunfu Shi, Pengcheng Yu, Yi Wang, Zhehan Bao, Yuhang Xia, Jiancheng Sun, Weiyang He, Tianhui Chen, Xiaolei Chen, Can Hu, Yunlong Zhang, Changwu Dong, Ping Zhao, Yanan Wang, Nan Jiang, Bin Lv, Yingwei Xue, Baoping Jiao, Hongyu Gao, Kequn Chai, Jun Li, Hao Wang, Xibo Wang, Xiaoqing Guan, Xu Liu, Gang Zhao, Zhichao Zheng, Jie Yan, Hou–Yong Yu, Luchuan Chen, Zaisheng Ye, H You, Yu Bao, Xi Cheng, Pei-Zheng Zhao, Liang Wang, Wenting Zeng, Yanfei Tian, Ming Chen, You You, Guihong Yuan, Hua Ruan, Xiaole Gao, Jingli Xu, Handong Xu, Lingbin Du, Shengjie Zhang, Huanying Fu, Xiangdong Cheng · 发表于：EClinicalMedicine · 年份：2023 · DOI：10.1016/j.eclinm.2023.101834 · 被引用次数：167 · 研究领域：Traditional Chinese Medicine Studies、Advanced Chemical Sensor Technologies、Traditional Chinese Medicine Analysis

Background: Tongue images (the colour, size and shape of the tongue and the colour, thickness and moisture content of the tongue coating), reflecting the health state of the whole body according to the theory of traditional Chinese medicine (TCM), have been widely used in China for thousands of years. Herein, we investigated the value of tongue images and the tongue coating microbiome in the diagnosis of gastric cancer (GC). Methods: From May 2020 to January 2021, we simultaneously collected tongue images and tongue coating samples from 328 patients with GC (all newly diagnosed with GC) and 304 non-gastric cancer (NGC) participants in China, and 16 S rDNA was used to characterize the microbiome of the tongue coating samples. Then, artificial intelligence (AI) deep learning models were established to evaluate the value of tongue images and the tongue coating microbiome in the diagnosis of GC. Considering that tongue imaging is more convenient and economical as a diagnostic tool, we further conducted a prospective multicentre clinical study from May 2020 to March 2022 in China and recruited 937 patients with GC and 1911 participants with NGC from 10 centres across China to further evaluate the role of tongue images in the diagnosis of GC. Moreover, we verified this approach in another independent external validation cohort that included 294 patients with GC and 521 participants with NGC from 7 centres. This study is registered at ClinicalTrials.gov, NCT01090362. Findings: For t...