临床新进展

深度学习在早期胃癌内镜图像诊断中的研究进展

  • 张倩 ,
  • 曹云太 ,
  • 王志洁 ,
  • 周伯琪
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  • 青海大学附属医院医学影像中心 (青海 西宁 810000 )
曹云太,医学博士,副主任医师,副教授,博士研究生导师,青海大学附属医院医务部副主任,青海省昆仑英才·高端创新创业拔尖人才,中国科学院“西部之光”青年学者。擅长腹部及心血管影像诊断;科研方向:腹部影像学,医学大数据及人工智能;先后在清华大学、北京协和医学院、中山大学肿瘤防治中心进修学习。学术任职及荣誉:中国医师协会放射医师分会继续教育组委员,中国民族卫生协会放射学分会科学研究组/青年委员,中国康复医学会医学影像与康复专委会智能影像与康复学组委员,中国生物工程学会生物医药大数据专委会委员,青海省医学会放射学分会委员,青海省医师协会放射学分会委员,青海省抗癌协会放射学分会委员,iRADIOLOGY《融合影像学(英文)》青年编委。主持国家自然科学基金项目1项,主持省市级科研项目4项。获甘肃省科技进步奖一等奖1项。以第一作者或通信作者发表SCI论文及中文核心期刊论文30余篇,北美放射学会(RSNA)录用10余篇、国际磁共振大会(ISMAR)录用3篇、世界抗癌大会(WCC)论文1篇,中华医学会放射学分会录用10余篇。

收稿日期: 2025-04-21

  网络出版日期: 2025-07-29

基金资助

医学影像中心国家级临床重点专科项目(202490)

Advances in deep learning for endoscopic image⁃based diagnosis of early gastric cancer

  • Qian ZHANG ,
  • Yuntai CAO ,
  • Zhijie WANG ,
  • Boqi. ZHOU
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  • Department of Medical Imaging,Affiliated Hospital of Qinghai University,Xining 810000,Qinghai,China

Received date: 2025-04-21

  Online published: 2025-07-29

摘要

胃癌作为全球高发恶性肿瘤,因临床症状隐匿性导致多数患者在确诊时已进展至中晚期,严重影响治疗效果与生存质量。早期胃癌的精准筛查与病理特征解析是制定个体化治疗方案的核心环节。内镜技术虽作为胃癌早期筛查的金标准,但其诊断准确性高度依赖于操作者的经验和技术水平,目前在人工智能技术赋能下正实现诊疗规范式的革新。基于深度学习的计算机视觉系统可高效识别早期胃癌迹象,其不仅提升病灶辨识灵敏度,更能实现早期胃癌关键病理特征的智能评估,为临床决策提供可视化诊疗依据。该文旨在梳理深度学习技术在早期胃癌内镜图像分析中的应用进展并探讨其临床应用价值。

本文引用格式

张倩 , 曹云太 , 王志洁 , 周伯琪 . 深度学习在早期胃癌内镜图像诊断中的研究进展[J]. 实用医学杂志, 2025 , 41(14) : 2160 -2166 . DOI: 10.3969/j.issn.1006-5725.2025.14.006

Abstract

Gastric carcinoma (GC), a highly prevalent malignant tumor globally, often progresses to advanced stages by the time of diagnosis due to its insidious clinical presentation, thereby significantly reducing therapeutic effectiveness and patient quality of life. Accurate screening and histopathological characterization of early gastric cancer (EGC) are essential for developing individualized treatment approaches. Although endoscopic techniques remain the gold standard for early GC detection, their diagnostic accuracy is largely dependent on the operator′s skill, a challenge that current artificial intelligence (AI)-assisted innovations aim to address by standardizing diagnostic procedures. Deep learning (DL)-based computer vision systems have demonstrated remarkable performance in identifying subtle EGC features, not only improving lesion detection sensitivity but also enabling automated assessment of key pathological indicators. These technological advances offer objective, visualized diagnostic support for clinical decision-making. This review provides a systematic overview of recent developments in DL applications for endoscopic image analysis of EGC and evaluates their potential for clinical integration.

参考文献

[1] 张希, 杨雷, 刘硕,等. 2022年全球恶性肿瘤统计报告解读[J]. 中华肿瘤杂志,2024,46(7):710-721.
[2] JOSHI S S, BADGWELL B D. Current treatment and recent progress in gastric cancer[J]. CA Cancer J Clin, 2021,71(3):264-279. doi:10.3322/caac.21657
[3] 曹晖, 张子臻, 赵恩昊,等. 对早期胃癌内镜治疗的评价、思考及展望[J]. 中国实用外科杂志,2022,42(10):1097-1103.
[4] 严超, 陆晟, 燕敏,等. 《日本胃癌治疗指南2021(第6版)》解读及瑞金实践[J]. 外科理论与实践,2023,28(4):326-354.
[5] 徐惠绵, 潘四维. 胃癌诊治研究进展2021年度盘点[J]. 肿瘤学杂志,2022,28(2):81-85.
[6] XIANG Y, YAO L. Retrospective Analysis of Diagnosis and Treatment of Gastric Cancer at Huzhou Central Hospital[J]. Altern Ther Health Med, 2023,29(8):302-309.
[7] MURAKAMI D, YAMATO M, AMANO Y, et al. Challenging detection of hard-to-find gastric cancers with artificial intelligence-assisted endoscopy[J]. Gut, 2021,70(6):1196-1198. doi:10.1136/gutjnl-2020-322453
[8] 李茁钰, 刘凯, 张维汉,等. 全球及中国胃癌的流行病学特点及趋势:2018-2022《全球癌症统计报告》解读[J]. 中国普外基础与临床杂志,2024,31(10):1236-1245.
[9] ZHOU J, LI R, ZHAO S, et al. Sentinel Node Navigation Surgery for Early Gastric Cancer: A Narrative Review[J]. Am J Clin Oncol, 2024,47(9):439-444. doi:10.1097/coc.0000000000001101
[10] HU H, GONG L, DONG D, et al. Identifying early gastric cancer under magnifying narrow-band images via deep learning:A multicenter study[J]. Gastrointest Endosc, 2020,93(6):1333-1341.e3. doi:10.1016/j.gie.2020.11.014
[11] ZHU Y, WU K, WANG F Y. Efficacy of Magnifying Endoscopy with Narrow-Band Imaging in the Diagnosis of Early Gastric Cancer and Gastric Intraepithelial Neoplasia[J]. Turk J Gastroenterol, 2024,35(4):299-306.
[12] YOSHIDA T, DOHI O, SEYA M, et al. Diagnostic Ability of Magnifying Endoscopy Compared to Biopsy Examination for Early Gastric Cancer prior to Endoscopic Submucosal Dissection[J]. Dig Dis, 2025,43(3):358-367. doi:10.1159/000544045
[13] 徐自慧, 徐爱蕾, 刘美纯,等. 血清胃功能检测联合内镜精查在早期胃癌筛查中的意义[J]. 临床消化病杂志,2025,37(2):86-88.
[14] 周伯琪, 曹云太, 杨瑷如,等. 影像组学及深度学习在预测结直肠癌相关基因突变的研究进展[J]. 磁共振成像,2025,16(2):198-203.
[15] FENG J, ZHANG Y, FENG Z, et al. A prospective and comparative study on improving the diagnostic accuracy of early gastric cancer based on deep convolutional neural network real-time diagnosis system (with video)[J]. Surg Endosc, 2025,39(3):1874-1884. doi:10.1007/s00464-025-11527-5
[16] JIANG B, BAO L, HE S, et al. Deep learning applications in breast cancer histopathological imaging:Diagnosis, treatment, and prognosis[J]. Breast Cancer Res, 2024,26(1):137. doi:10.1186/s13058-024-01895-6
[17] FAKHOURI H N, ALAWADI S, AWAYSHEH F M, et al. A cognitive deep learning approach for medical image processing[J]. Sci Rep, 2024,14(1):4539. doi:10.1038/s41598-024-55061-1
[18] ZHANG H, ZHAO Y, KANG H, et al. Multi-Input Deep Convolutional Neural Network Model for Short-Term Power Prediction of Photovoltaics[J]. Comput Intell Neurosci, 2022,2022:9350169. doi:10.1155/2022/9350169
[19] 窦越群, 吴海波, 于勇,等. 超低剂量CT扫描结合深度学习图像重建对计算机辅助诊断系统定量分析肺结节的影响[J]. 中国介入影像与治疗学,2024,21(7):418-422.
[20] 程兆瑞,王彤.人工智能技术在肝细胞癌诊断、复发及预后预测研究进展[J].中山大学学报(医学科学版),2023,44(6):903-909.
[21] 韩英妹, 李一杰, 张衡,等. 深度学习在阿尔茨海默病疾病转化预测影像学研究中的应用价值[J]. 实用医学杂志,2025,41(9):1413-1424.
[22] 陈哲, 李文洁, 韩旭,等. 人工智能技术在消化系统疾病诊断中应用的研究进展[J]. 国际消化病杂志,2022,42(2):81-85.
[23] SAKAI Y, TAKEMOTO S, HORI K, et al. Automatic detection of early gastric cancer in endoscopic images using a transferring convolutional neural network[J]. Annu Int Conf IEEE Eng Med Biol Soc, 2018,2018:4138-4141. doi:10.1109/embc.2018.8513274
[24] LI L, CHEN Y, SHEN Z, et al. Convolutional neural network for the diagnosis of early gastric cancer based on magnifying narrow band imaging[J]. Gastric Cancer, 2020,23(1):126-132. doi:10.1007/s10120-019-00992-2
[25] WANG L, YANG Y, YANG A, et al. Lightweight deep learning model incorporating an attention mechanism and feature fusion for automatic classification of gastric lesions in gastroscopic images[J]. Biomed Opt Express, 2023,14(9):4677-4695. doi:10.1364/boe.487456
[26] LING T, WU L, FU Y, et al. A deep learning-based system for identifying differentiation status and delineating the margins of early gastric cancer in magnifying narrow-band imaging endoscopy[J]. Endoscopy, 2021,53(5):469-477. doi:10.1055/a-1229-0920
[27] ZHANG L, ZHANG Y, WANG L, et al. Diagnosis of gastric lesions through a deep convolutional neural network[J]. Dig Endosc, 2021,33(5):788-796. doi:10.1111/den.13844
[28] UEYAMA H, KATO Y, AKAZAWA Y, et al. Application of artificial intelligence using a convolutional neural network for diagnosis of early gastric cancer based on magnifying endoscopy with narrow-band imaging[J]. J Gastroenterol Hepatol, 2021,36(2):482-489. doi:10.1111/jgh.15190
[29] GAN T, YANG Y, LIU S, et al. Automatic Detection of Small Intestinal Hookworms in Capsule Endoscopy Images Based on a Convolutional Neural Network[J]. Gastroenterol Res Pract, 2021,2021:5682288. doi:10.1155/2021/5682288
[30] HIRASAWA T, AOYAMA K, TANIMOTO T, et al. Application of artificial intelligence using a convolutional neural network for detecting gastric cancer in endoscopic images[J]. Gastric Cancer, 2018,21(4):653-660. doi:10.1007/s10120-018-0793-2
[31] YAO Z, JIN T, MAO B, et al. Construction and Multicenter Diagnostic Verification of Intelligent Recognition System for Endoscopic Images From Early Gastric Cancer Based on YOLO-V3 Algorithm[J]. Front Oncol, 2022,12:815951. doi:10.3389/fonc.2022.815951
[32] 郭宪, 吴应洋, 江艾芮,等. 基于深度学习的人工智能辅助胃镜下实时识别病变及位置模型的建立[J]. 局解手术学杂志,2024,33(10):849-854.
[33] KIM B S, KIM B, CHO M, et al. Enhanced multi-class pathology lesion detection in gastric neoplasms using deep learning-based approach and validation[J]. Sci Rep, 2024,14(1):11527. doi:10.1038/s41598-024-62494-1
[34] 金涛, 姚镇东, 毛伯能,等. 人工智能YOLO-V8算法构建早期胃癌图像检测系统的临床意义[J]. 临床肿瘤学杂志,2025,30(3):261-267.
[35] JIN J, ZHANG Q, DONG B, et al. Automatic detection of early gastric cancer in endoscopy based on Mask region-based convolutional neural networks (Mask R-CNN)(with video)[J]. Front Oncol, 2022,12:927868. doi:10.3389/fonc.2022.927868
[36] ZHANG K, WANG H, CHENG Y, et al. Early gastric cancer detection and lesion segmentation based on deep learning and gastroscopic images[J]. Sci Rep, 2024,14(1):7847. doi:10.1038/s41598-024-58361-8
[37] 姚敏佳,宋文爱,孙雪,等.InstantMesh:早期胃癌图像三维重建方法研究[J/OL].计算机与现代化,1-9(2025-04-14)[2025-04-16]..
[38] TERAMOTO A, SHIBATA T, YAMADA H, et al. Detection and Characterization of Gastric Cancer Using Cascade Deep Learning Model in Endoscopic Images[J]. Diagnostics (Basel), 2022,12(8):1996. doi:10.3390/diagnostics12081996
[39] GOTO A, KUBOTA N, NISHIKAWA J, et al. Cooperation between artificial intelligence and endoscopists for diagnosing invasion depth of early gastric cancer[J]. Gastric Cancer, 2023,26(1):116-122. doi:10.1007/s10120-022-01330-9
[40] KIM J H, OH S I, HAN S Y, et al. An Optimal Artificial Intelligence System for Real-Time Endoscopic Prediction of Invasion Depth in Early Gastric Cancer[J]. Cancers (Basel), 2022,14(23):6000. doi:10.3390/cancers14236000
[41] CHEN T H, KUO C F, LEE C, et al. Artificial Intelligence Model for a Distinction between Early-Stage Gastric Cancer Invasive Depth T1a and T1b[J]. J Cancer, 2024,15(10):3085-3094. doi:10.7150/jca.94772
[42] YEO M K, PARK J H, KANG S H, et al. The long-term outcome and risk factors of histologic discrepancy between forceps biopsies and endoscopic resections in early gastric cancer: An observational study[J]. Medicine (Baltimore), 2024,103(23):e38451. doi:10.1097/md.0000000000038451
[43] WU L, WANG J, HE X, et al. Deep learning system compared with expert endoscopists in predicting early gastric cancer and its invasion depth and differentiation status (with videos)[J]. Gastrointest Endosc, 2022,95(1):92-104.e3. doi:10.1016/j.gie.2021.06.033
[44] 丁平安, 杨沛刚, 田园,等. 胃癌伴左锁骨上淋巴结转移患者的临床病理特征及预后[J]. 实用医学杂志,2021,37(13):1695-1700.
[45] LEE S, JEON J, PARK J, et al. Correction: An artificial intelligence system for comprehensive pathologic outcome prediction in early gastric cancer through endoscopic image analysis (with video)[J]. Gastric Cancer, 2024,27(6):1351. doi:10.1007/s10120-024-01549-8
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