ABSTRACT
OBJECTIVE: To explore the guiding significance of artificial intelligence for clinical practice of breast cancer after operation,and to evaluate the concordance of the Watson for oncology(WFO)with the breast cancer treatment guidelines of NCCN and Chinese Anti-Cancer Association.METHODS: A total of 100 patients who were diagnosed as breast cancer after accepting surgical operations from January 2016 to December 2017 in China-Japan Union Hospital of Jilin University were enrolled.The expressions of ER,PR,Her-2 and Ki-67 protein in cancer tissues after operation were detected by using immunohistochemitry,and inputed the clinical cases information of these 100 patients into the WFO system.Finally,the treatment recommendations were compared with the breast cancer treatment guidelinesof NCCN and the China Anticancer Association.The Kappa test was used to determine the concordance.RESULTS: There were 64 cases(64%)of all 100 patients with the same treatment plans,the clinical stage Ⅱ(42/44 cases,95.5%)to Ⅲ(15/16 cases,93.6%)and triple negative breast cancer(7/8 cases,87.5%)treatment showed a higher concordance(Kappa value ≥ 0.75);The age≥ 41 years old,Luminal A of the immunophenotype and pathological grade Ⅲ also had a certain concordance,and the concordance of 41-55 years old were average,but it is not ideal of the cases that older than 55 years old or the pathological grade Ⅲ;On the contrary,the treatment recommendations of clinical stage Ⅰ(7/40 cases,17.5%),especially for both the lymph node metastasis negative were very inconsistency(Kappa value <0).But there was no statistical significance in the cases of the age ≤ 41 years old,pathological gradeⅠto Ⅱ,Luminal B and HER-2 type of immunophenotype.CONCLUSION: WFO in the patients of clinical stageⅡ to Ⅲ and triple negative breast cancer(P<0.05)has a certain reference value in the afore-mentioned situations;And WFO could be considering in the cases of age ≥ 41 years of age or older,Luminal A of immunophenotype and pathological grade Ⅲ;In contrast,for clinical stage Ⅰ of early breast cancer patients,WFO is not recommended.WFO could offer some reasonable treatment recommendations in partial patients with artificial intelligent computer system,and it may provide clinical decisionsupport for clinicians,and it has some guiding significance in breast cancer postoperative clinical practice,clinical learning and research.