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多模态协同“一站式”子宫颈癌医防融合体系的建设和临床应用
吴乙时, 陈彦东, 崔满华, 谭文溪, 程琳, 周旭, 赵菁, 张春苗, 张钰琪, 王洪鑫, 张春雪, 李婷婷, 许天敏
中国实用妇科与产科杂志 ›› 2025, Vol. 41 ›› Issue (10) : 1034-1038.
PDF(2346 KB)
PDF(2346 KB)
多模态协同“一站式”子宫颈癌医防融合体系的建设和临床应用
Construction and clinical application of a multimodal collaborative “one-stop” integrated healthcare and prevention system for cervical cancer
目的 探讨创建多模态协同“一站式”子宫颈癌医防融合体系,助力加快消除子宫颈癌。方法 收集2022年6月至2025年3月于吉林大学第二医院妇科诊断为人乳头瘤病毒(HPV)感染或子宫颈上皮内病变或子宫颈癌32 250例患者的门诊、住院、随访过程中全部诊疗信息,通过患者主索引(EMPI)技术动态整合相关数据,采用结构化电子病历、限制性勾选、强制校验等方式以及“人工+人工智能(AI)”随访模式,建立覆盖疾病全周期的子宫颈癌信息化管理体系。结果 体系应用后,子宫颈癌筛查服务能力显著增强,高级别鳞状上皮内病变(HSIL)及以上病变的阳性检出率由7.2%提升至12.4%(P<0.0001)。随访质量提高,累计完成12 434例次随访,平均复诊率达89.2%,电话访视率达100%;术后2年内HPV阳性检出率由27.4%升至47.1%(P<0.0001)。术前分期率从83.8%提升至92.3%(P<0.0001),诊疗规范性显著改善。同时,成功研发了阴道镜AI辅助诊断模型及双阶段子宫颈疾病风险预测模型[HPV感染预测曲线下面积(AUC)=0.9266,HSIL风险预测AUC=0.8429]。结论 多模态协同“一站式”子宫颈癌医防融合体系的建立与应用实现诊疗闭环管理,助力临床科研创新,推动省级防治协同,为区域化子宫颈癌防治提供了可推广的新范式。
Objective To establish a multimodal collaborative "one-stop" integrated healthcare and prevention system for cervical cancer in order to help accelerate the elimination of cervical cancer. Methods All clinical data from outpatients,inpatients and follow-up visits of patients, who were diagnosed with HPV infection,cervical intraepithelial neoplasia,or cervical cancer, totally 32 250 patients, were collected from the Department of Gynecology at the Second Hospital of Jilin University from June 2022 to March 2025. Utilizing Enterprise Master Patient Index (EMPI) technology,the relevant data were dynamically integrated. A structured electronic medical record system,restricted selection fields,mandatory validation,and a combined "manual+AI" follow-up mode were employed to establish an informatics-based management system for cervical cancer that covered the entire disease cycle. Results Implementation of the system significantly enhanced screening capacity for cervical cancer,with the detection rate of HSIL+ increasing from 7.2% to 12.4% (P<0.0001). Follow-up quality was improved,with 12 434 times of follow-up completed, an average return visit rate being 89.2%,and a telephone follow-up rate being 100%. The postoperative HPV positivity rate within two years of surgery increased from 27.4% to 47.1% (P<0.0001). The preoperative staging rate was improved from 83.8% to 92.3% (P<0.0001),reflecting better compliance with standardized clinical pathways. Furthermore,an AI-assisted colposcopic diagnosis model and a two-stage cervical disease risk prediction model were successfully developed(HPV infection prediction AUC=0.9266;HSIL risk prediction AUC=0.8429). Conclusion The establishment and application of the multimodal collaborative "one-stop" integrated healthcare and prevention system for cervical cancer have realized closed-loop management of the clinical pathway,facilitating clinical and scientific research innovation and promoting the provincial-level prevention and treatment collaboration,which provides a new replicable paradigm for regional prevention and treatment of cervical cancer.
子宫颈癌 / 肿瘤防治体系 / 多模态专病库 / 人工智能 / 信息化管理
cervical cancer / cancer prevention and management system / multimodal disease-specific database / artificial intelligence (AI) / health informatics management
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