Diagnosis of early colorectal cancer using SHAP diagrams of combined models of electroviscoelastic parameters of erythrocytes and the level of fatty acids in their membranes

The purpose of the work: to investigate the possibilities of combined models including electrical, viscoelastic parameters of erythrocytes, fatty acid levels of erythrocyte membranes, blood serum to improve the accuracy of early colorectal cancer (CRC) diagnosis. Materials and methods. 65 patients with stages 1-2 of CRC (mean age 63.3±9.6 years), 25 people with adenomatous polyps (AP) and 35 people of the comparison group were examined. The electrical and viscoelastic parameters of erythrocytes were studied by dielectrophoresis in the frequency range 5x10⁴-10⁶Hz; the levels of fatty acids (FA) in erythrocyte membranes, blood serum - using gas chromatography/mass spectrometry (Agilent 7000B (USA). When creating combined models, machine learning methods were used, for their interpretation and assessment of the degree of contribution of parameters to their composition, the method of constructing SHAP diagrams was used. Results. The use of combined models made it possible to achieve high diagnostic accuracy of distinction: for the pair “healthy versus patients with AP” during ROC analysis, the AUC was 1,0 (sensitivity 1,0, specificity 1,0). This model included parameters: diameter of erythrocytes at a frequency of 10⁶Hz, proportion of deformed cells, summerized rigidity, amplitude of cell deformation at a frequency of 10⁶Hz, speed of movement of erythrocytes to electrodes, electrical conductivity of cells, level of arachidonic acid, aggregation index at a frequency of 5x10⁴Hz, polarizability at a frequency of 10⁶Hz, total content of eicosapentaenoic and docosahexaenoic (n3), level of docosatetraenoic FA (n6). For the pair “healthy vs patients with 1-2 stages of CRC”, the AUC also reached 1,0 (an increase in AUC from 0.916 when using only FA to 1.0 in combined models) (sensitivity 1,0, specificity 1,0); the most significant for the distinction were: electrical conductivity, cell capacity, erythrocyte level of palmitooleiс C16:1;9 FA, the position of the crossover frequency, summerized rigidity, the amplitude of cell deformation at a frequency of 10⁶ Hz, the degree of cell deformation at a frequency of 5x10⁵ Hz, the level of the dipole moment, the total content of serum saturated FA, the proportion of deformed cells, serum levels myristic, palmitic FA, the rate of movement of erythrocytes to the electrodes, the level of docozapentaenoic C22:5n-3 in the blood serum. For the pair “patients with 1-2 stages of CRC versus patients with AP”, the AUC was 0,98 (sensitivity 0,92, specificity 1,0). This model consisted of indicators: the diameter of erythrocytes at different frequencies of the electric field, the level of decadienic FA (n6) in erythrocyte membranes, the proportion of discocytic forms, the content of stearic FA in erythrocytes, the serum level of palmitoleic C16:1;9 FA, the total content of saturated FA, aggregation indices at low frequencies of NUAEF, the level of pentadecanoic FA in erythrocyte membranes, serum stearic acid content and cell polarizability at a frequency of 10⁶ Hz. Conclusion. The creation of combined models consisting of electrical, viscoelastic parameters of erythrocytes, fatty acid levels of erythrocyte membranes, blood serum using machine learning methods and the construction of SHAP diagrams ensures high accuracy in the diagnosis of precancerous and early colorectal cancer.

colorectal cancer, adenomatous polyps, diagnostics, combined models, electrical, viscoelastic parameters of erythrocytes, fatty acids, SHAP diagrams

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