Human pathology最新文献

{"title":"Significance of mucin-suspended tumor bud-like structures in colorectal cancer","authors":"Ville K. Äijälä ,&nbsp;Päivi Sirniö ,&nbsp;Hanna Elomaa ,&nbsp;Henna Karjalainen ,&nbsp;Meeri Kastinen ,&nbsp;Vilja V. Tapiainen ,&nbsp;Maarit Ahtiainen ,&nbsp;Olli Helminen ,&nbsp;Erkki-Ville Wirta ,&nbsp;Jukka Rintala ,&nbsp;Sanna Meriläinen ,&nbsp;Juha Saarnio ,&nbsp;Tero Rautio ,&nbsp;Toni T. Seppälä ,&nbsp;Jan Böhm ,&nbsp;Jukka-Pekka Mecklin ,&nbsp;Anne Tuomisto ,&nbsp;Markus J. Mäkinen ,&nbsp;Juha P. Väyrynen","doi":"10.1016/j.humpath.2025.105772","DOIUrl":"10.1016/j.humpath.2025.105772","url":null,"abstract":"<div><div>Tumor budding (TB) is an independent predictor of adverse prognosis in colorectal cancer (CRC), defined as clusters of fewer than 5 tumor cells at the invasive margin of cancer. According to the international consensus criteria (ITBCC), TB should be evaluated from the non-mucinous regions. However, some tumors also contain tumor bud-like structures within extracellular mucin pools, and the prognostic impact of these structures remains unclear. To assess this, we defined a modified tumor budding variable (TB-Muc), representing the highest number of tumor buds/bud-like structures observed in a hotspot (0.785 mm²) at the invasive margin, including extracellular mucin regions. We analyzed the prognostic significance of TB (ITBCC criteria) and TB-Muc in two CRC cohorts (N = 1876). TB-ITBCC was associated with advanced stage and lymphovascular invasion (p &lt; 0.001) but also with shorter cancer-specific survival independent of other prognostic factors (Cohort 1: HR for high vs. low 1.99, 95 % CI 1.32–3.01, p_trend = 0.0007; Cohort 2: HR 1.35, 95 % CI 0.98–1.85, p_trend = 0.037). TB-Muc had a comparable independent association with shorter cancer-specific survival (Cohort 1: HR for high vs. low 1.77, 95 % CI 1.18–2.65, p_trend = 0.006; Cohort 2: HR 1.39, 95 % CI 1.02–1.89, p_trend = 0.019). Our results indicate that tumor bud-like structures in mucin do not provide additional prognostic value and should not be included in TB evaluation.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"158 ","pages":"Article 105772"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydroa vacciniforme lymphoproliferative disorder, a clinicopathologic and genetic analysis","authors":"Weiwei Zhang ,&nbsp;George Pupwe ,&nbsp;Liliana Vasquez ,&nbsp;Yasodha Nakunam ,&nbsp;Atif Saleem ,&nbsp;Hernan Molina-Kirsch ,&nbsp;Brady Beltran ,&nbsp;Ivan Maza Medina ,&nbsp;Mauricio Postigo ,&nbsp;Joo Y. Song ,&nbsp;Wing C. Chan","doi":"10.1016/j.humpath.2025.105770","DOIUrl":"10.1016/j.humpath.2025.105770","url":null,"abstract":"<div><div>Hydroa vacciniforme lymphoproliferative disorder (HV-LPD) is a rare Epstein–Barr virus (EBV)-associated disease and the systemic form shows a propensity to progress and some cases may eventually develop a disease simulating NK/T-cell lymphoma or even aggressive NK-cell leukemia. We report 12 patients with systemic HV-LPD of median age 15.8 years with dermatosis involving the face, trunk, extremities and serous membranes. Ten of 12 patients (83 %) had systemic symptoms including 9 with prominent facial edema and 2 with bone marrow involvement. All cases were positive for EBER and CD3 and lacked CD20. Additional positive markers included CD8 in 11 of 12 (91.6 %), CD56 in 1 of 12 (8.3 %), granzyme B in 6 of 7 (85.7 %), TIA1 in 2 of 2 (100 %) and CD30 in 1 of 3 (33.3 %). Two cases studied demonstrated monoclonal TCR-γ and one also had TCR-β rearrangements. Five cases were sequenced and showed recurrent mutations in <em>ALMS1, ALPK2, BCORL1</em>, KANK2, <em>KMT2D</em>, <em>NCOR1</em>, <em>PTPRD,</em> RHOA, TNIK, <em>TP53</em> and <em>ZFHX3</em>, and single cases showed a variety of mutations including <em>BCOR, CREBBP, DDX3X, DMXL2, IRF4, IRF8, KDM6A, MGA, NCOR2, PLCG1, PRDM1, RNF213, SMARCA4, STAT5B and TET2</em> mutation<em>.</em> Most patients were treated with immunomodulating therapy, two received methotrexate, three received multiagent chemotherapy and one underwent hematopoietic stem cell transplant. Follow-up was available in 10 patients of whom 6 died of disease and one was alive without disease. Our results showed that patients with persistent/progressive systemic HV-LPD have a poor prognosis and did not respond well to chemotherapy. The mutation spectrum bore some resemblance to extranodal NK/T lymphomas but also had notable differences.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"158 ","pages":"Article 105770"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of NPM1 mutation frequency in cutaneous blastic plasmacytoid dendritic cell neoplasms","authors":"Hanan Hamdan ,&nbsp;Alexa Siddon ,&nbsp;Maximiliano Ramia de Cap ,&nbsp;Sharon Germans ,&nbsp;Miguel D. Cantu ,&nbsp;Franklin Fuda ,&nbsp;Travis Vandergriff ,&nbsp;Nidhi Aggarwal ,&nbsp;Olga K. Weinberg","doi":"10.1016/j.humpath.2025.105766","DOIUrl":"10.1016/j.humpath.2025.105766","url":null,"abstract":"<div><h3>Background</h3><div>Blastic plasmacytoid dendritic cell neoplasm (BPDCN) and acute myeloid leukemia (AML) show overlapping clinicopathological presentations, which makes it challenging to differentiate on a small skin biopsy. <em>NPM1</em> mutations are the most common genetic lesions in AML, accounting for one third of cases and cause an aberrant cytoplasmic delocalization of <em>NPM1</em> mutants, which can be detected by an immunohistochemical stain. Frequency of <em>NPM1</em> mutations in BPDCN remains controversial. We aimed to investigate <em>NPM1</em> mutations in cutaneous BPDCN cases and compare them with cutaneous <em>NPM1</em> positive leukemia cutis cases.</div></div><div><h3>Methods</h3><div>From a multi-institutional search, we identified and analyzed 13 cases of cutaneous BPDCN and 19 cases of cutaneous myeloid sarcoma (7 of which were primary leukemia cutis) with <em>NPM1</em> mutations. We compared the clinical and pathological findings of these patients and identified distinguishing features between these groups.</div></div><div><h3>Results</h3><div>BPDCN patients presented at an older age, with lower white blood cell count, higher hemoglobin level, and elevated platelets counts as compared to cutaneous myeloid sarcoma patients (p &lt; 0.05). The bone marrow of patients in both groups was similarly involved at the time of diagnosis with no significant difference in rate; however, the percentage of involvement was significantly different among the two groups. Complex karyotype was more frequently seen in BPDCN patients (37.5 %) as compared with 15.7 % of cutaneous myeloid sarcoma patients (p &lt; 0.05). Mutational profile differed among the two groups with absence of <em>NPM1</em> mutations in BPDCN cases. Comparison of co-mutations detected in both groups revealed that BPDCN cases were significantly enriched in <em>IDH2, NRAS,</em> and <em>SRSF2</em> mutations.</div></div><div><h3>Conclusion</h3><div>We find that BPDCN patients present in a similar way to cutaneous AML patients but appear to uniformly lack <em>NPM1</em> mutations. Our study suggests that NPM1 can be used as a surrogate immunohistochemical stain to differentiate this rare disease from myeloid sarcoma in a rapid and cost-effective method.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"158 ","pages":"Article 105766"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in papillary tumors of breast.","authors":"Raza S Hoda, Hannah Y Wen","doi":"10.1016/j.humpath.2025.105759","DOIUrl":"10.1016/j.humpath.2025.105759","url":null,"abstract":"<p><p>This review addresses common diagnostic challenges associated with papillary breast tumors-a rare but significant category of breast lesions. Despite their low incidence, papillary tumors are frequently encountered in breast pathology consultation practice due to their overlapping terminology and perplexing immunohistochemical results. Issues regarding assessment of invasive carcinoma in the setting of solid papillary carcinoma and encapsulated papillary carcinoma are covered. Emerging entities, such as tall cell carcinoma with reversed polarity and invasive lobular carcinoma mimicking solid papillary carcinoma, are discussed. Additionally, pragmatic guidance is provided for managing papillary breast tumors on needle core biopsy. Herein, we aim to provide clarity and confidence to surgical pathologists dealing with papillary breast tumors-mammary Medusa-equipping them with practical knowledge to better navigate this complex area of breast pathology.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"105759"},"PeriodicalIF":2.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary urethral adenocarcinoma harbors recurrent KRAS and EGFR alterations","authors":"Ting Zhao,&nbsp;A. John Iafrate,&nbsp;Chin-Lee Wu","doi":"10.1016/j.humpath.2025.105771","DOIUrl":"10.1016/j.humpath.2025.105771","url":null,"abstract":"<div><div>Primary urethral adenocarcinoma is an extremely rare malignancy with an unclear pathogenesis. Previously, we reported 4 brachytherapy-associated (BA) urethral mucinous adenocarcinomas that developed following treatment for prostate cancer. In the present study, we report one additional BA and 3 radiation-independent (RI) urethral adenocarcinomas. The aim of this study is to explore the molecular alterations and to compare the clinicopathologic features.</div><div>RNA sequencing was performed on 5 tumors, and a next-generation sequencing (NGS)-based fusion assay was used to identify gene fusions in 6 tumors. Additionally, NGS-based targeted genomic DNA sequencing was employed to analyze one metastatic BA tumor and one metastatic RI tumor.</div><div>The 8 patients had a mean age of 67 (range: 37–87) years, with one being female in the RI cohort. Cystoscopy revealed the following urethral findings: a papillary lesion (4/7), mass causing obstruction (1/7) and irregular friable tissue (2/7). Seven patients underwent urethrectomy with cystectomy/prostatectomy/hysterectomy. The mean tumor size was 3.4 cm (range: 1.5–6.5). Adenocarcinoma in situ was noted in 5 tumors. All 5 BA tumors originated from the prostatic urethra, with 4 showing mucinous morphology and one enteric morphology, and showed moderate to poor differentiation and tumor stages of pT2 (2/4), pT3 (1/3) and pT4 (1/4). Two patients developed metastasis, one at 3.3 and one at 4.2 years after diagnosis, and all patients were alive at a median follow-up of 4.5 (range: 2–14) years. In contrast, 3 RI tumors arose from bulbar, prostatic, or female mid/distal urethra, presenting as enteric, mucinous, and not otherwise specified (NOS) subtypes, with well to moderate differentiation and a tumor stage of pT4 (2/2). Two died of the disease, while one was alive without disease at a median follow-up of 4 (range: 2.2–14.5) years. All tumors were diffusely positive for CK20, CDX2 (7/7), and AMACR (3/3), and lacked nuclear β-catenin expression (5/5). Most expressed CK7 (5/7). <em>KRAS</em> mutations (p.Gly12Val and p.Gly13Asp) were observed in one BA mucinous tumor and one RI NOS tumor with the p.Gly13Asp mutation also detected in the metastatic RI tumor. The <em>EGFR</em> p.Ser784Phe mutation was detected in one RI enteric tumor. <em>TP53</em> p.Val172Phe, <em>CDKN2A</em> p.Leu32_Leu37del, and amplifications of <em>EGFR</em> and <em>MDM2</em>, were identified in a metastatic BA enteric tumor. No fusion transcripts were identified.</div><div>In conclusion, urethral adenocarcinoma harbors recurrent <em>KRAS</em> and <em>EGFR</em> alterations, independent of prior radiotherapy. RI tumors appear to be associated with a worse prognosis compared to BA tumors.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"157 ","pages":"Article 105771"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Authors","authors":"","doi":"10.1016/S0046-8177(25)00064-4","DOIUrl":"10.1016/S0046-8177(25)00064-4","url":null,"abstract":"","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"157 ","pages":"Article 105777"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examination of the histogenesis of epithelial cysts in angiomyolipoma with epithelial cysts (AMLEC) using GPNMB and TSC2 immunostains","authors":"Huili Li ,&nbsp;Oluwademilade Dairo ,&nbsp;Tamara Lotan ,&nbsp;Pedram Argani ,&nbsp;Andres Matoso","doi":"10.1016/j.humpath.2025.105764","DOIUrl":"10.1016/j.humpath.2025.105764","url":null,"abstract":"<div><div>Angiomyolipoma with epithelial cysts (AMLECs) is an uncommon subtype of angiomyolipoma (AML), with both a classic AML component and a bland epithelial-lined cystic component. The histogenesis of the cysts in AMLECs is unclear. Two main hypotheses have been proposed: the cysts represent entrapped dilated native tubules versus the epithelial differentiation of AML. Mutations of tuberous sclerosis genes are frequently observed in AML. Glycoprotein non-metastatic melanoma protein B (GPNMB) exhibits a low expression in most normal tissues and is transcriptionally activated by TFE3 and TFEB. Loss of TSC1/2/mTOR function paradoxically activates TFE3 and TFEB, resulting in a strong diffuse GPNMB expression. We explored the histogenesis of epithelial cysts in five AMELC cases using HMB45, Cathepsin-K, GPNMB and TSC2 immunostains. GPNMB was strongly and diffusely positive in the classic spindle cell component in all five AMLECs, but not in the cystic epithelium and associated blood vessels. Correspondingly, loss of TSC2 labeling was only seen in the classic spindle cell AML but not in the cystic epithelium and vessels. HMB45 was positive in the classic spindle cell component and not in the cystic epithelium or blood vessels. Cathepsin-K stained both spindle and epithelial components but was weaker in the epithelium. Our study demonstrates that strong diffuse expression of GPNMB correlates with loss of TSC2 expression. The epithelial cysts and associated vessels in AMLECs do not harbor TSC pathway alteration, thus supporting the idea that they are entrapped native tubules and vasculatures, not part of the neoplasia.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"157 ","pages":"Article 105764"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular mapping in head and neck adenoid cystic carcinoma by pathological grade using whole-exome sequencing and spatial transcriptome","authors":"Yuelu Zhu ,&nbsp;Lin Li ,&nbsp;Shun Wang ,&nbsp;Bingzhi Wang ,&nbsp;Lin Dong,&nbsp;Zhe Zhang,&nbsp;Ying Wang,&nbsp;Jiangtao Li,&nbsp;Haifeng Zhang,&nbsp;Haizhen Lu","doi":"10.1016/j.humpath.2025.105758","DOIUrl":"10.1016/j.humpath.2025.105758","url":null,"abstract":"<div><div>Our previous study demonstrated that pathological grades of adenoid cystic carcinoma (ACC) correlate with distinct prognoses and treatment strategies. To explore the molecular alterations underlying these grades, we performed whole-exome sequencing (WES) on 20 head and neck ACC samples from 12 patients, categorized into grade I-II, grade III, and high-grade transformation (HGT). Comprehensive analyses, including somatic mutations, chromosomal structural variations, and phylogenetic tree construction, were conducted. Spatial transcriptome (ST) technology was further employed to analyze gene expression, pseudo-time trajectories, and copy number variations in a grade III sample. WES revealed that high-grade (grade III and HGT) ACC tissues frequently harbor mutations in TP53, PI3K pathway genes, and chromatin remodelers. Phylogenetic analysis showed that higher-grade regions exhibit more subclonal mutations or a larger proportion of intergenerational mutations. Copy number analysis identified recurrent deletions of 1p36.33 and amplifications of 8q24.21/9p24.1 in high-grade samples, along with significant deletions on chr12 in both WES and ST. ST pathway enrichment and cell trajectory analyses indicated that high-grade clusters are more primitive and proliferative, while low-grade clusters display greater microenvironmental stability and interstitial specialization. These findings highlight the complex spatial heterogeneity associated with ACC pathological grades, providing critical insights into disease progression and guiding therapeutic strategies.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"157 ","pages":"Article 105758"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological study of 34 cases of clear cell adenocarcinoma of the urinary tract and diagnostic value of SOX 17 in its differential diagnosis","authors":"Lan Zheng ,&nbsp;Georges Tabet ,&nbsp;Charles C. Guo ,&nbsp;Yasmeen Oamar Rizvi ,&nbsp;Maria Gabriela Raso ,&nbsp;Jinsong Liu ,&nbsp;Qingqing Ding ,&nbsp;Ezra Baraban ,&nbsp;Jianping Zhao","doi":"10.1016/j.humpath.2025.105767","DOIUrl":"10.1016/j.humpath.2025.105767","url":null,"abstract":"<div><div>Clear cell adenocarcinoma (CCA) of the urinary tract is a rare tumor with a female predominance. The morphological features and immunoprofile of urinary CCA, CCA of the gynecologic tract (Gyn CCA), and nephrogenic adenoma (NA) can show extensive overlap, and the differential diagnosis can be challenging especially in small biopsies. SOX17 is a newly identified sensitive and specific immunomarker for endometrial and ovarian carcinomas including Gyn CCA. However, its expression in urinary CCA and NA has not been studied. We studied clinical and pathological features of 34 cases of urinary CCA, the largest cohort in the literature to date. We analyzed the expression pattern of SOX17 in a cohort of 34 urinary CCA, 24 Gyn CCA, and 18 NA. Interestingly, 29 % (10/34) of urinary CCA showed high SOX17 expression, while all the NA cases (18/18) showed negative-low expression. In female, 51 % of urinary CCA cases (15/29) show negative-low expression of SOX17, whereas all Gyn CCA (24/24) showed high SOX17 positivity. Our study showed a unique expression pattern of SOX17 in urinary CCA and NA. These results suggest that SOX17 is a useful marker in distinguishing CCA from NA or urinary CCA from Gyn CCA. Moreover, our study suggests different pathogenic pathways for the histogenesis of urinary CCA.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"157 ","pages":"Article 105767"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143790751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inside front cover - Masthead","authors":"","doi":"10.1016/S0046-8177(25)00061-9","DOIUrl":"10.1016/S0046-8177(25)00061-9","url":null,"abstract":"","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"157 ","pages":"Article 105774"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}