Objective To evaluate the clinical radiological features combined with circulating tumor cells (CTCs) in the diagnosis of invasiveness evaluation of subsolid nodules in lung cancers. Methods Clinical data of 296 patients from the First Hospital of Lanzhou University between February 2019 and February 2021 were retrospectively included. There were 130 males and 166 females with a median age of 62.00 years. Patients were randomly divided into a training set and an internal validation set with a ratio of 3 : 1 by random number table method. The patients were divided into two groups: a preinvasive lesion group (atypical adenomatoid hyperplasia and adenocarcinoma in situ) and an invasive lesion group (microinvasive adenocarcinoma and invasive adenocarcinoma). Independent risk factors were selected by regression analysis of training set and a Nomogram prediction model was constructed. The accuracy and consistency of the model were verified by the receiver operating characteristic curve and calibration curve respectively. Subgroup analysis was conducted on nodules with different diameters to further verify the performance of the model. Specific performance metrics, including sensitivity, specificity, positive predictive value, negative predictive value and accuracy at the threshold were calculated. Results Independent risk factors selected by regression analysis for subsolid nodules were age, CTCs level, nodular nature, lobulation and spiculation. The Nomogram prediction mode provided an area under the curve (AUC) of 0.914 (0.872, 0.956), outperforming clinical radiological features model AUC [0.856 (0.794, 0.917), P=0.003] and CTCs AUC [0.750 (0.675, 0.825), P=0.001] in training set. C-index was 0.914, 0.894 and corrected C-index was 0.902, 0.843 in training set and internal validation set, respectively. The AUC of the prediction model in training set was 0.902 (0.848, 0.955), 0.913 (0.860, 0.966) and 0.873 (0.730, 1.000) for nodule diameter of 5-20 mm, 10-20 mm and 21-30 mm, respectively. Conclusion The prediction model in this study has better diagnostic value, and is more effective in clinical diagnosis of diseases.
ObjectiveTo investigate the effect of an artificial intelligence (AI)-powered voice cloning education system based on the self-reference effect on patient outcomes, and to compare the educational effects of a physician's voice versus the patient's own voice. MethodsA prospective, three-arm, parallel-group randomized controlled trial was conducted. A total of 150 thoracic surgery inpatients at the First Hospital of Lanzhou University from May to September 2025 were included and randomly assigned in a 1 : 1 : 1 ratio to a traditional education group (control group, n=50), a physician’s voice-cloned AI education group (intervention group 1, n=50), and a patient's own voice-cloned AI education group (intervention group 2, n=50). The primary outcome was the education content compliance rate, which was automatically assessed using the DeepSeek-R1 model. Secondary outcomes included knowledge mastery, educational satisfaction, treatment adherence, quality of life (SF-36), and psychological status (HADS). ResultsA total of 145 (96.7%) patients completed the trial. There were no significant differences in age [(54.2±10.1) years, (55.8±9.7) years, and (53.9±10.5) years, respectively] or sex distribution (male/female: 28/20, 26/22, and 27/22, respectively) among the three groups (all P>0.05). The immediate post-education content compliance rates of both AI intervention groups were significantly higher than that of the control group (P<0.001). The patient’s own voice-cloned AI education group was significantly superior to the physician's voice-cloned AI education group and the control group in terms of knowledge mastery at discharge, treatment adherence at the 1-month follow-up, and anxiety and depression scores at the 1-month follow-up (all P<0.05). ConclusionAn AI-powered education model leveraging the self-reference effect throughpatient’s own voice cloning significantly improves patient outcomes. This approach demonstrates superior results in knowledge retention, treatment adherence, and psychological well-being compared to traditional methods and physician’s voice cloning, offering a new paradigm for personalized and scalable intelligent health education.
