{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:49:14Z","timestamp":1790704154240,"version":"4.1.0"},"reference-count":52,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T00:00:00Z","timestamp":1675123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Natural Science Foundation of China, China","award":["81225025"],"award-info":[{"award-number":["81225025"]}]},{"name":"National Natural Science Foundation of China, China","award":["62061160369"],"award-info":[{"award-number":["62061160369"]}]},{"name":"National Natural Science Foundation of China, China","award":["BNR2019TD01020"],"award-info":[{"award-number":["BNR2019TD01020"]}]},{"name":"National Natural Science Foundation of China, China","award":["BNR2019RC01012"],"award-info":[{"award-number":["BNR2019RC01012"]}]},{"name":"Beijing National Research Center for Information Science and Technology, China","award":["81225025"],"award-info":[{"award-number":["81225025"]}]},{"name":"Beijing National Research Center for Information Science and Technology, China","award":["62061160369"],"award-info":[{"award-number":["62061160369"]}]},{"name":"Beijing National Research Center for Information Science and Technology, China","award":["BNR2019TD01020"],"award-info":[{"award-number":["BNR2019TD01020"]}]},{"name":"Beijing National Research Center for Information Science and Technology, China","award":["BNR2019RC01012"],"award-info":[{"award-number":["BNR2019RC01012"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Screening patients with precancerous lesions of gastric cancer (PLGC) is important for gastric cancer prevention. The accuracy and convenience of PLGC screening could be improved with the use of machine learning methodologies to uncover and integrate valuable characteristics of noninvasive medical images related to PLGC. In this study, we therefore focused on tongue images and for the first time constructed a tongue image-based PLGC screening deep learning model (AITongue). The AITongue model uncovered potential associations between tongue image characteristics and PLGC, and integrated canonical risk factors, including age, sex, and Hp infection. Five-fold cross validation analysis on an independent cohort of 1995 patients revealed the AITongue model could screen PLGC individuals with an AUC of 0.75, 10.3% higher than that of the model with only including canonical risk factors. Of note, we investigated the value of the AITongue model in predicting PLGC risk by establishing a prospective PLGC follow-up cohort, reaching an AUC of 0.71. In addition, we developed a smartphone-based app screening system to enhance the application convenience of the AITongue model in the natural population from high-risk areas of gastric cancer in China. Collectively, our study has demonstrated the value of tongue image characteristics in PLGC screening and risk prediction.<\/jats:p>","DOI":"10.3390\/jpm13020271","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T02:52:02Z","timestamp":1675219922000},"page":"271","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Construction of Tongue Image-Based Machine Learning Model for Screening Patients with Gastric Precancerous Lesions"],"prefix":"10.3390","volume":"13","author":[{"given":"Changzheng","family":"Ma","sequence":"first","affiliation":[{"name":"Institute of TCM-X\/MOE Key Laboratory of Bioinformatics, Bioinformatics Division, BNRist\/Department of Automation, Tsinghua University, Beijing 100084, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Institute of TCM-X\/MOE Key Laboratory of Bioinformatics, Bioinformatics Division, BNRist\/Department of Automation, Tsinghua University, Beijing 100084, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyu","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, China-Japan Friendship Hospital, Chaoyang District, Beijing 100029, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine, Yijishan Hospital of Wannan Medical College, Wuhu 241000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8709-9167","authenticated-orcid":false,"given":"Shao","family":"Li","sequence":"additional","affiliation":[{"name":"Institute of TCM-X\/MOE Key Laboratory of Bioinformatics, Bioinformatics Division, BNRist\/Department of Automation, Tsinghua University, Beijing 100084, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2606","DOI":"10.1016\/S0140-6736(16)32226-7","article-title":"The challenge of screening for early gastric cancer in China","volume":"388","author":"Zong","year":"2016","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1136\/gut.47.2.251","article-title":"The Vienna classification of gastrointestinal epithelial neoplasia","volume":"47","author":"Schlemper","year":"2000","journal-title":"Gut"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"h3867","DOI":"10.1136\/bmj.h3867","article-title":"Incidence of gastric cancer among patients with gastric precancerous lesions: Observational cohort study in a low risk Western population","volume":"351","author":"Song","year":"2015","journal-title":"BMJ"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1053\/j.gastro.2008.01.071","article-title":"Gastric cancer risk in patients with premalignant gastric lesions: A nationwide cohort study in the Netherlands","volume":"134","author":"Looman","year":"2008","journal-title":"Gastroenterology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1053\/j.gastro.2020.11.017","article-title":"The Colombian Chemoprevention Trial: 20-Year Follow-Up of a Cohort of Patients with Gastric Precancerous Lesions","volume":"160","author":"Piazuelo","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1136\/gutjnl-2017-314600","article-title":"Gastritis staging in the endoscopic follow-up for the secondary prevention of gastric cancer: A 5-year prospective study of 1755 patients","volume":"68","author":"Rugge","year":"2019","journal-title":"Gut"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s12967-019-1816-4","article-title":"A robust qualitative transcriptional signature for the correct pathological diagnosis of gastric cancer","volume":"17","author":"Yan","year":"2019","journal-title":"J. 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