皮肤疣人工智能诊断模型的构建及诊断跖疣的有效性评价

Development of an artificial intelligence diagnostic model for cutaneous warts and evaluation of its diagnostic efficacy for plantar warts

  • 摘要: 背景 皮肤疣是我军官兵的高发传染病,严重影响日常工作和生活,但基层医务人员缺乏诊断跖疣的临床能力。目的 构建皮肤疣人工智能诊断模型,为提高基层医务人员诊断跖疣的水平提供简单可靠的方法。方法 纳入2022 年11 月至2024 年12 月解放军总医院第九医学中心皮肤科就诊的跖疣、寻常疣、胼胝及鸡眼患者,收集皮肤疣(跖疣、寻常疣)及非疣(胼胝、鸡眼)皮损的手机和皮肤镜图像。按8:2 比例将患者随机分为训练集和验证集,分别采用Swin Transformer-Base、ResNet、Vision Transformer 和ConvNeXt核心架构构建手机和皮肤镜诊断模型,根据验证集的准确率、敏感性、特异性和受试者工作特征曲线(receiver operating characteristic,ROC)下面积(area under the curve,AUC)筛选最优模型。收集2025 年1 月至2026 年1 月解放军总医院3 个医学中心相同类型皮损的手机和皮肤镜图像用于临床测试。以高年资皮肤科医生诊断结果为金标准,评估最优模型诊断跖疣的效果。结果 共收集皮肤疣皮损手机图像600 张、皮肤镜图像417 张,非疣皮损手机图像142 张、皮肤镜图像96 张,用于构建诊断模型;收集跖疣皮损手机图像及对应皮肤镜图像各103 张,非疣皮损手机图像及对应皮肤镜图像各19 张,用于临床测试。Swin Transformer-Base 诊断模型效果最优。其中,手机模型验证集的准确率为0.919、敏感性为0.950、特异性为0.793、AUC=0.972;皮肤镜模型验证集的准确率为0.952、敏感性为0.964、特异性为0.905、AUC=0.993。在临床测试集中,手机模型的准确率为0.943、敏感性为0.961、特异性为0.842、AUC=0.986;皮肤镜模型的准确率为0.975、敏感性为0.990、特异性为0.895、AUC=0.995。两种模型诊断效性差异无统计学意义(P>0.05)。结论 本研究构建基于Swin Transformer-Base 的手机和皮肤镜皮肤疣诊断模型能够准确诊断跖疣,提高基层医务人员诊断水平。

     

    Abstract: Background Cutaneous warts are highly prevalent infectious diseases among military personnel, severely disrupting their daily work and lives. However, primary medical staff lack the clinical proficiency to diagnose plantar warts. Objective To construct an artificial intelligence diagnostic model for cutaneous warts to provide a simple and reliable method for improving the capacity of primary medical staff in diagnosing plantar warts. Methods Patients with plantar warts, common warts, calluses, and corns who visited the Dermatology Department of the Ninth Medical Center of PLA General Hospital from November 2022 to December 2024 were included. Smartphone photographs and dermoscopic images of lesions, including cutaneous warts (plantar warts, common warts) and non-wart lesions (calluses, corns), were collected. Patients were randomly assigned to the training set or validation set at an 8: 2 ratio. Diagnostic models based on smartphone images and dermoscopic images were constructed using Swin Transformer-Base, ResNet, Vision Transformer, and ConvNeXt architectures, respectively. The optimal model was selected according to performance metrics, including accuracy, sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC), in the validation set. Smartphone photographs and dermoscopic images of identical plantar warts and non-wart lesions were collected from three medical centers of the Chinese PLA General Hospital from January 2025 to January 2026 for clinical testing. With the diagnostic conclusions of senior dermatologists as the gold standard, the performance of the optimal model for diagnosing plantar warts was evaluated. Results A total of 600 smartphone images and 417 dermoscopic images of cutaneous wart lesions, as well as 142 smartphone images and 96 dermoscopic images of non-wart lesions, were collected for diagnostic model construction. For clinical testing, 103 smartphone images and paired dermoscopic images of the same plantar wart lesions were obtained; meanwhile, 19 smartphone images and paired dermoscopic images of identical non-wart lesions were collected. The Swin Transformer-Base model achieved the optimal diagnostic performance for cutaneous warts. For the smartphone image-based model, the accuracy, sensitivity, specificity, and AUC on the validation set were 0.919, 0.950, 0.793, and 0.972, respectively. For the dermoscopy-based model, the corresponding indicators on the validation set were 0.952, 0.964, 0.905, and 0.993. In the clinical test set, the smartphone image-based model yielded an accuracy of 0.943, sensitivity of 0.961, specificity of 0.842, and AUC of 0.986; the dermoscopy-based model attained an accuracy of 0.975, sensitivity of 0.990, specificity of 0.895, and AUC of 0.995. No statistically significant difference was found between the diagnostic performance of the smartphone image-based model and the dermoscopy-based model (P>0.05).Conclusion The Swin Transformer-Base model established in this study for diagnosing cutaneous warts based on smartphone and dermoscopic images can accurately identify plantar warts and has potential auxiliary application to improve the diagnostic proficiency of primary medical staff for plantar warts.

     

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