JMIR Publications

ABSTRACT

Tuberculosis (TB) is a precipitating cause of lung cancer. Lung cancer patients coexisting with TB is difficult to differentiate from isolated TB patients. The aim of this study is to develop a prediction model in identifying those two diseases between the comorbidities and TB. In this work, based on the laboratory data from 389 patients, 81 features, including main laboratory examination of blood test, biochemical test, coagulation assay, tumor markers and baseline information, were initially used as integrated markers and then reduced to form a discrimination system consisting of 31 top-ranked indices. Patients diagnosed with TB PCR ＞1mtb/ml as negative samples, lung cancer patients with TB were confirmed by pathological examination and TB PCR ＞1mtb/ml as positive samples. We used Spatially Uniform ReliefF (SURF) algorithm to determine feature importance, and the predictive model was built using machine learning algorithm Random Forest. For cross-validation, the samples were randomly split into four training set and one test set. The selected features are composed of four tumor markers (Scc, Cyfra21-1, CEA, ProGRP and NSE), fifteen blood biochemical indices (GLU, IBIL, K, CL, Ur, NA, TBA, CHOL, SA, TG, A/G, AST, CA, CREA and CRP), six routine blood indices (EO#, EO%, MCV, RDW-S, LY# and MPV) and four coagulation indices (APTT ratio, APTT, PTA, TT ratio). This model presented a robust and stable classification performance, which can easily differentiate the comorbidity group from the isolated TB group with AUC, ACC, sensitivity and specificity of 0.8817, 0.8654, 0.8594 and 0.8656 for the training set, respectively. Overall, this work may provide a novel strategy for identifying the TB patients with lung cancer from routine admission lab examination with advantages of being timely and economical. It also indicated that our model with enough indices may further increase the effectiveness and efficiency of diagnosis.