Human pathology最新文献

{"title":"Severe eosinophilic gastritis is associated with peripheral eosinophilia and multi-organ involvement","authors":"Xintong Wang ,&nbsp;Yansheng Hao ,&nbsp;Hansen Lam ,&nbsp;Qingqing Liu ,&nbsp;Huaibin M. Ko","doi":"10.1016/j.humpath.2025.105932","DOIUrl":"10.1016/j.humpath.2025.105932","url":null,"abstract":"<div><div>Histologic gastric eosinophilia (HGE), characterized by dense eosinophil infiltration in gastric mucosa, is an understudied disease with unclear etiology. Unlike its counterpart, eosinophilic esophagitis (EoE), which has defined diagnostic eosinophil thresholds and characteristic endoscopic findings, proposed eosinophil thresholds for the diagnosis of HGE vary and endoscopic findings are not well characterized.</div><div>This study aimed to assess the clinical, histological, and endoscopic features of HGE in adults and children. A cohort of 50 HGE patients were identified (20 children, 30 adults; 58.0 % male). The majority (70.0 %) had an allergic/atopic history. Pediatric patients with HGE were significantly more likely to have a history of food allergy (P = 0.013) and less likely to have drug allergy (P = 0.001) compared to adults.</div><div>The most common endoscopic finding was ulceration/erosion (34.0 %). Multiorgan GI-tract involvement was seen in 40.9 % of patients, primarily affecting the esophagus (39.0 %) and duodenum (15.4 %).</div><div>HGE cases were stratified by severity into G1 (50–100 eosinophils/HPF; 11 patients) and G2 (&gt;100 eosinophils/HPF; 39 patients) groups for comparison. Patients with G2 HGE had higher rates of peripheral eosinophilia (P = 0.010) and multiorgan GI involvement (P = 0.047) compared to those with G1 HGE.</div><div>In conclusion, HGE often presents as a gastric ulcer and is strongly associated with food allergy in children and drug allergy in adults. Severe HGE is more likely than moderate HGE to present with peripheral eosinophilia and concomitant eosinophilia elsewhere in the GI tract, therefore, noting the presence of severe HGE may be helpful in guiding clinical follow up.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"164 ","pages":"Article 105932"},"PeriodicalIF":2.6,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026426","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":"Centrosome dysfunction and autophagy dysregulation in renal cell carcinoma: Implications for tumor progression and therapy.","authors":"Hung-Hsiang Huang, Won-Jing Wang, Yu-Ching Peng","doi":"10.1016/j.humpath.2025.105929","DOIUrl":"https://doi.org/10.1016/j.humpath.2025.105929","url":null,"abstract":"<p><p>Renal cell carcinoma (RCC) is a heterogeneous kidney malignancy driven by complex genetic, molecular, and metabolic alterations. Emerging evidence implicates centrosome dysfunction and autophagy dysregulation in RCC initiation, progression, and resistance to therapy. The centrosome plays a critical role in mitotic fidelity, and its dysfunction often leads to chromosomal and genomic instability. Autophagy, a lysosome-dependent process essential for cellular homeostasis, exhibits a dual role in RCC. It functions as a tumor suppressor in early stages but promotes tumor survival and resistance to therapy in advanced disease. Notably, recent studies indicate that TFEB/TFE3, transcription factors that regulate autophagy and lysosomal biogenesis, mediate a functional interplay between centrosome status and autophagy. This review aims to explore the mechanistic crosstalk between centrosome dysfunction and autophagy in RCC, with a special focus on MiT family translocation RCC, and to discuss emerging therapeutic strategies targeting these pathways.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"105929"},"PeriodicalIF":2.6,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029433","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":"Assessment of Nectin4-expression in vulvar squamous cell carcinomas (VSCC): correlation with HPV-associated and HPV-independent molecular subtypes","authors":"Anne Kathrin Höhn ,&nbsp;Grit Gesine Ruth Hiller ,&nbsp;Benjamin Wolf ,&nbsp;Mirjam Forberger ,&nbsp;Christine E. Brambs ,&nbsp;Blake Gilks ,&nbsp;Lien Hoang ,&nbsp;Jessica N. McAlpine ,&nbsp;Amy Jamieson ,&nbsp;Lars-Christian Horn","doi":"10.1016/j.humpath.2025.105926","DOIUrl":"10.1016/j.humpath.2025.105926","url":null,"abstract":"<div><h3>Background</h3><div>The development of antibody-drug conjugates (ADC) for cancer treatment has achieved promising results in different solid tumors and targets. Enfortumab-Vedotin (EV), a humanised anti-Nectin4-IgG1 monoclonal antibody linked to the microtubule-disrupting agent monomethyl auristatin E (MMAE), is an FDA-approved Nectin4-directed ADC for the treatment of locally advanced or metastatic pre-treated urothelial cancer. Targeted therapy with EV requires the expression of Nectin4 within the tumor cells. The present study evaluates Nectin4 expression in vulvar squamous cell carcinomas (VSCC) and its correlation to different VSCC molecular subtypes.</div></div><div><h3>Methods</h3><div>Immunohistochemical Nectin4-expression was evaluated semiquantitatively on diagnostic biopsies of VSCC using an immunoreactive score (IRS). There was a correlation between IRS and different molecular subtypes of VSCC.</div></div><div><h3>Results</h3><div>All 55 cases showed at least weak Nectin4 expression within the tumor cells with a median IRS of 6.0 (range 2–6) indicating high expression levels in most tumors. Moderate/high expression (IRS ≥4) was more frequent in HPV-associated tumors (p16^+ve/p53 ^wt molecular subtype: 12/14 (85.7 %) when compared to HPV-independent VSCC (22/35 (62.9 %) in p16^−ve/p53^abn and 0 % in four p16^−ve/p53 ^wt) VSCC, a difference that is not statistically significant.</div></div><div><h3>Conclusion</h3><div>Most VSCC show high expression of Nectin4, including the HPV-independent VSCC containing a <em>TP53</em>-mutation (p16^−ve/p53^abn molecular subtype), that are associated with the worst prognosis. Therefore, Nectin4-directed ADC such as Enfortumab-Vedotin (EV) may present a potential treatment option in VSCC. Nectin4-expression can easily be assessed by immunohistochemistry on diagnostic biopsies. Clinical trials exploring Nectin4-directed ADCs such as EV are necessary.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"164 ","pages":"Article 105926"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000461","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":"Invasive urothelial carcinoma with chordoid and myxoid features shows increased RAS/RAF pathway alterations.","authors":"Emily Chan, Bradley A Stohr, Ankur R Sangoi, Deepika Sirohi","doi":"10.1016/j.humpath.2025.105882","DOIUrl":"10.1016/j.humpath.2025.105882","url":null,"abstract":"<p><p>Invasive urothelial carcinoma (UCa) with chordoid and myxoid features is an uncommon but previously described subtype of UCa composed of distinctive elongated nests and cords of tumor cells floating within a prominent myxoid stroma. The molecular features of chordoid and myxoid UCa are not known. We identified 9 cases of UCa with chordoid and myxoid features and performed a comprehensive next generation sequencing assay, targeting the chordoid and myxoid component. The cases included 7 TURBT and 2 nephroureterectomies in which the chordoid/myxoid component ranged from 10 to 80 % (mean 47 %). Available immunohistochemistry in the chordoid and myxoid component showed p63+ (9/9) and GATA3+ (8/9), supporting UCa. All cases were largely negative for SOX10 and CDX2 (one case showed weak CDX2 staining). On molecular analysis, chordoid and myxoid UCa showed a molecular profile typical of conventional UCa, with recurrent alterations in TERTp (7/9), chromatin remodeling genes (8/9) and cell cycle pathway genes (8/9). A high rate of DNA damage repair gene alterations was also seen (6/9). Interestingly, 5/9 cases demonstrated recurring alterations in RAS/RAF pathway genes, a finding typically more frequently seen in primary adenocarcinomas of the urinary bladder and less common in conventional UCa, and also suggesting possible alternative therapies for these patients. In conclusion, chordoid and myxoid UCa shows a genomic profile with both urothelial and adenocarcinoma features. Furthermore, the molecular profile reveals potentially actionable therapeutic targets in the RAS/RAF and DNA damage repair pathways and high tumor mutational burden.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"105882"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768596","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":"Mixed-grade papillary urothelial carcinoma with a minor high-grade component shows a significantly worse clinical outcome than low-grade papillary urothelial carcinoma.","authors":"William Mi, Chenxuan Zang, Jianping Zhao, Ashish M Kamat, Peng Wei, Donna E Hansel, Bogdan Czerniak, Charles C Guo","doi":"10.1016/j.humpath.2025.105904","DOIUrl":"10.1016/j.humpath.2025.105904","url":null,"abstract":"<p><p>Grade heterogeneity is common in papillary urothelial carcinoma (PUC) of the urinary bladder. Mixed-grade PUC is generally treated as high-grade if the high-grade component accounts for ≥5 % of the tumor. However, the clinical behavior of predominantly low-grade PUC with a minor high-grade (<5 %) component remains uncertain. We retrospectively searched our pathology files and identified 52 cases of non-invasive mixed-grade PUC (predominantly low-grade PUC with a minor high-grade (<5 %) component). These patients' clinical outcomes were compared with those of 2 other cohorts, 52 cases of pure low-grade PUC and 50 high-grade PUC. During follow-up, 27 patients with mixed-grade PUC developed cancer recurrence in an average of 25 months, and 12 patients experienced progression to high-grade PUC, including invasive UC in 3 patients, in an average of 17 months. For comparison, 35 patients with low-grade PUC experienced cancer recurrence in an average of 17 months, but only 1 (2 %) experienced progression to high-grade non-invasive PUC; 34 patients with high-grade PUC experienced recurrence in an average of 13 months, and 10 (20 %) experienced progression to invasive UC. There was no significant difference in cancer recurrence in the 3 cohorts; cancer grade and stage progression rates in patients with mixed-grade PUC were significantly higher than those in those with low-grade PUC, but stage progression rate in patients with mixed-grade PUC was significantly lower than that in high-grade PUC. In conclusion, patients with mixed-grade PUC had a significantly worse clinical outcome than those with pure low-grade PUC but a significantly better outcome than those with high-grade PUC. Our results suggest that mixed-grade PUC should be treated as a distinct category from low-grade PUC.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"105904"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803991","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":"Association between p16^INK4A expression and a treatment response to CDK4/6 inhibitor in advanced breast carcinoma.","authors":"Xiao Huang, Shuko Harada, Shi Wei, Gene P Siegal, Sarah A Anderson, Aysegul A Sahin, Katia Khoury, Ceren Yalniz","doi":"10.1016/j.humpath.2025.105905","DOIUrl":"10.1016/j.humpath.2025.105905","url":null,"abstract":"<p><strong>Introduction: </strong>Endocrine therapy combined with cyclin-dependent kinase 4 and 6 inhibitors (1) has been approved for patients with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative breast carcinomas. It has been known that the p16-CDK4/6-cyclin D1 axis regulates the S phase of the cell cycle. We investigated the association between p16 expression and the therapeutic response with CDK4/6i in advanced breast carcinoma.</p><p><strong>Methods: </strong>Patients diagnosed with invasive breast carcinoma between 2019 and 2024 whose tumors underwent next-generation sequencing (NGS) based analysis were identified. The expression of p16 was assessed in tumor cells and stromal cells within the invasive carcinoma by immunohistochemistry. In tumor cells, p16 expression was subclassified as cytoplasmic (TC), nuclear (TN), or cytoplasmic and nuclear staining (TCN). In stromal cells, p16 expression was assessed in tumor-associated fibroblasts (TAF) and tumor-infiltrating immune cells (TILs) in any cellular compartment.</p><p><strong>Results: </strong>Among the 35 cases, p16-TC, -TN, and -TCN were significantly associated with disease progression during CDK4/6i therapy. The positive association between p16-TC and progressive disease remained in the 24 CDK4/6i-treatment naïve tumors. In contrast, the tumors with p16 expression in TAF showed a numerically higher response rate than the p16-TAF-negative ones. We also observed a significant association between p16-TC expression and lymph node metastasis.</p><p><strong>Conclusion: </strong>Our study demonstrated a significant association between p16 expression in tumor cells and an unfavorable therapeutic response to CDK4/6i in advanced breast carcinoma. The clinical significance of p16 expression patterns as a predictive biomarker for CDK4/6i deserves further investigation.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"105905"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803990","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":"Impact of neoadjuvant chemotherapy on PD-L1 expression in oral squamous cell carcinoma: A matched biopsy-resection study","authors":"Deeksha Agrawal ,&nbsp;Nidhi Anand ,&nbsp;Nuzhat Husain ,&nbsp;Pallavi Srivastava ,&nbsp;Akash Tamrakar ,&nbsp;Vikas Sharma ,&nbsp;Ashish Singhal ,&nbsp;Rohini Khurana","doi":"10.1016/j.humpath.2025.105927","DOIUrl":"10.1016/j.humpath.2025.105927","url":null,"abstract":"<div><h3>Background</h3><div>Programmed death ligand 1 (PD-L1) is essential for immune evasion and serves as a significant biomarker for immunotherapy in oral squamous cell carcinoma (OSCC). Nevertheless, the changes in its expression after neoadjuvant chemotherapy (NACT) are not well understood. This research sought to assess the variations in PD-L1 expression between matched pretreatment biopsy samples and post-NACT surgical specimens, while also correlating these results with clinicopathological characteristics.</div></div><div><h3>Materials and methods</h3><div>The study comprised 130 patients with OSCC, of which 95 were treated with NACT while 35 acted as controls who did not receive NACT. PD-L1 expression was measured via immunohistochemistry (SP263 clone) on pretreatment biopsy samples and corresponding post-NACT resection specimens, employing Tumor Proportion Score (TPS), Immune Proportion Score (IPS), and Combined Positive Score (CPS) at several cut-off points (≥1 %, ≥10 %, ≥25 %, and ≥50 %). Statistical evaluations were performed using SPSS version 24.0.</div></div><div><h3>Results</h3><div>In post NACT, there was a significant variation in PD-L1 expression. A marked reduction in PD-L1 TPS was noted in T1 tumors, decreasing from 43.4 % to 13.0 % (p = 0.039), as well as in tumors with a depth of invasion (DOI) less than 5 mm, which dropped from 40.7 % to 14.8 %. Conversely, an increase in PD-L1 expression was observed in tumors at advanced nodal stages and those exhibiting lymphovascular invasion (LVI), perineural invasion (PNI), and tumor budding. The change in combined positive score (CPS) was significantly correlated with tumor budding (p = 0.008), the worst pattern of invasion (WPOI) (p = 0.036), DOI (p = 0.030), and prognostic stage (p = 0.026). In control cases, only minor alterations in PD-L1 status were detected between biopsy and resection specimens.</div></div><div><h3>Conclusion</h3><div>NACT did not lead to uniform or widespread changes in PD-L1 expression in OSCC. Significant alterations were limited to TPS in T1 tumors and CPS associations with certain pathological features, while most other comparisons showed no statistical significance. These findings suggest that PD-L1 expression after NACT should be interpreted cautiously, and larger studies are needed to clarify its clinical relevance. <strong>Keywords</strong>: Oral Squamous Cell Carcinoma; PD-L1 expression; Neoadjuvant treatment; Prognosis; Tumor proportion score; Combined positive score.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"164 ","pages":"Article 105927"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952177","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":"High-grade endometrioid carcinomas with pilomatrix-like features lacking CTNNB1 Mutations: Clinicopathologic characteristics and novel molecular events","authors":"Lei Qin ,&nbsp;Wanrun Lin ,&nbsp;Suming Huang ,&nbsp;Wenxin Zheng ,&nbsp;Feng Zhou","doi":"10.1016/j.humpath.2025.105928","DOIUrl":"10.1016/j.humpath.2025.105928","url":null,"abstract":"<div><h3>Context</h3><div>Pilomatrix-like high-grade endometrioid carcinoma (PiMHEC) represents a recently described, aggressive variant of endometrial carcinoma. Prior reports have linked PiMHEC with <em>CTNNB1</em> exon 3 mutations and abnormal nuclear β-catenin expression.</div></div><div><h3>Objective</h3><div>We aimed to expand the understanding a potential subclassification of PiMHEC by analyzing three new cases that lack <em>CTNNB1</em> mutations and β-catenin nuclear accumulation.</div></div><div><h3>Design</h3><div>Three cases of high-grade endometrioid carcinomas with pilomatrix-like features were identified and their clinical presentations and pathologic features reviewed. Immunohistochemistry (IHC) and targeted next-generation sequencing (NGS) were performed.</div></div><div><h3>Results</h3><div>All tumors demonstrated two components: a high-grade basaloid component with solid sheets of atypical basaloid cells, geographic necrosis, and focal “ghost” cells, and an associated low-grade FIGO grade 1 endometrioid carcinoma component. Notably, none of the three cases showed nuclear β-catenin expression by IHC, and all lacked <em>CTNNB1</em> exon 3 mutations. Despite this, the tumors fulfilled the morphologic criteria for PiMHEC described in prior studies and displayed aggressive clinical behavior. All the patients presented with advanced-stage disease (stages IIC–IVB), and two patients had a recurrence within 12 months. NGS revealed no <em>CTNNB1</em> mutations in any case, but identified alternative likely oncogenic alterations: one tumor harbored an <em>FGFR4 p.</em></div><div><em>T259A</em> mutation, two tumors had pathogenic <em>TSC2</em> mutations, one had a <em>KRAS p.G12D</em> mutation, and two showed <em>MYC</em> amplification, among other genetic changes.</div></div><div><h3>Conclusions</h3><div>High-grade endometrioid carcinomas with pilomatrix-like features lacking CTNNB1 mutations may represent a potential subclassification of PiMHEC, which exhibit aggressive behavior. CTNNB1-wildtype cases appear to rely on alternative oncogenic drivers, indicating that <em>CTNNB1</em> mutation maybe not an absolute requirement for the PiMHEC phenotype.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"164 ","pages":"Article 105928"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926222","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)00208-4","DOIUrl":"10.1016/S0046-8177(25)00208-4","url":null,"abstract":"","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"163 ","pages":"Article 105921"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144911464","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)00205-9","DOIUrl":"10.1016/S0046-8177(25)00205-9","url":null,"abstract":"","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"163 ","pages":"Article 105918"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912952","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}