International Journal of Gynecological Pathology最新文献

{"title":"Clinicopathological and Molecular Characterization of High Grade Endometrial Carcinomas of No Specific Molecular Profile (NSMP) Stratified by ER Status.","authors":"Patrick Thaddeus Timmermans, Alicia Leon-Castillo, Claire Kramer, Natalja Ter Haar, Vincentius Smit, Marie Boennelycke, Estrid Hogdall, Claus Hogdall, Carien L Creutzberg, Nanda Horeweg, Gitte Ortoft, Tjalling Bosse","doi":"10.1097/PGP.0000000000001112","DOIUrl":"https://doi.org/10.1097/PGP.0000000000001112","url":null,"abstract":"<p><p>This study represents a omprehensive characterization of high-grade endometrial carcinoma (EC) of no specific molecular profile (NSMP) to improve our understanding of their poor clinical outcome. A previously molecularly classified cohort of 412 high-grade EC from the Danish Cancer Registry was extensively reviewed by 2 expert pathologists blinded for associated clinical and molecular data. Immunohistochemistry (IHC) was performed to determine ER, PR, and L1CAM status and a 10% cut-off value was applied for positivity. Shallow whole-genomic sequencing (sWGS) and next-generation sequencing (NGS) was performed to describe the molecular landscape. Survival analysis was performed using the Kaplan-Meier method, and survival difference was tested using the log-rank test. Of the 57 high-grade NSMP tumors, ER negativity was found in 30 (53%). All clear cell NSMP EC (n=12, 21%) were ER negative. L1CAM overexpression was found in 29 high-grade NSMP EC (53%) and showed overlap (n=20, 69%) with ER negativity. A high frequency of copy number (CN) events and fraction genome altered (FGA) was observed, with the median number of CN events clustering by ER status (28 vs. 43, P<0.05). Overall, the cohort showed a 52% (CI: 31.6%, 72.4%) 5-yr overall survival (OS) and 61% (CI: 42.6%, 79.4%) 5-yr disease-specific survival (DSS). No significant additional prognostic refinement was found when stratifying for ER status (5-yr OS: 46% vs. 65%, P=0.068). High-grade NSMP ECs are a heterogenous group of tumors with high prevalence of loss of ER, L1CAM overexpression, and substantial copy number alterations. Within this group, no prognostic effect of ER was identified, providing support for grouping these tumors into one risk group. This work adds to the growing body of evidence that both high-grade and/or loss of ER expression can be used to identify NSMP EC patients with a poor clinical outcome.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Case of Ovarian Metastases From a Primary Retroperitoneal Mucinous Carcinoma Associated With Teratoma, With KRAS and ERBB3 Mutations: Case Report and Literature Review.","authors":"Jennifer Fallas, Isabelle Salmon, Calliope Maris, María Gómez Galdón, Nicky D'Haene, Jean-Christophe Noël, Xavier Catteau","doi":"10.1097/PGP.0000000000001073","DOIUrl":"https://doi.org/10.1097/PGP.0000000000001073","url":null,"abstract":"<p><p>Primary retroperitoneal mucinous carcinomas (PRMCa) are exceedingly rare and poorly understood neoplasms, with <80 cases documented in the medical literature and molecular profiling hardly ever performed. Recent theories suggest that PRMCa might develop from mature cystic teratomas or Brenner tumors, mirroring their ovarian counterparts. However, only 2 cases of primary retroperitoneal mucinous tumors associated with teratoma have been reported in the literature to support this idea. In this paper, we detail an exceptional case: a 66-yr-old woman with ovarian metastases stemming from a PRMCa that originated in a mature cystic teratoma. The patient initially presented with a long-standing cystic mass in the retroperitoneum, diagnosed as a mucinous carcinoma after surgical removal. Following initial resection, the patient experienced rapid metastatic progression requiring aggressive treatment. Interestingly, the later ovarian metastases exhibited the full spectrum of architectural complexity observed in the initial lesion. This \"maturation phenomenon,\" frequently observed in ovarian metastases of mucinous tumors, remains enigmatic. Molecular analysis revealed a KRAS mutation along with an ERBB3 mutation, making it the first instance of ERBB3 mutation being documented in this specific entity. This case underscores the importance of thorough data collection and continued research to improve our understanding of these rare tumors.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Maternal-Fetal Interface Fibrin Deposition and Expression of FGL2 in the Placenta of Preeclampsia and Fetal Growth Restriction.","authors":"Qihui Chen, Donglu Li, Yushuang Zheng, Xinran Li, Lu Wang, Wangzhi Li, Zheyu Lu, Fan Wang, Lingling Zhou","doi":"10.1097/PGP.0000000000001095","DOIUrl":"https://doi.org/10.1097/PGP.0000000000001095","url":null,"abstract":"<p><p>We aimed to assess fibrin deposition in placentas of patients with preeclampsia (PE) with fetal growth restriction (FGR) and the relationship with fibrinogen-like protein 2 (FGL2). In this case-control study, pregnant women with PE (n=48), PE with FGR (n=44), FGR (n=43), and healthy pregnant women (n=43) at term gestation were recruited. We compared the baseline characteristics, blood coagulation parameters, and placenta characteristics. Masson's trichrome staining was used to categorize 2 types of fibrinoid. FGL2 expression was examined by immunohistochemical staining. The PE+FGR placentas showed more obvious fetal and maternal vascular malperfusion and maternal-fetal interface fibrin deposition when compared with the others. Increased fibrin-type and matrix-type fibrinoids were found in the placenta of the PE+FGR group when compared with the controls. FGL2 was localized in the junction of these 2 types of fibrinoid, as well as extravillous trophoblastic layers and decidual stromal cells. The PE+FGR group had significantly lower FGL2 expression levels. Placental vascular malperfusion with massive maternal-fetal interface fibrin deposition was found in PE with FGR. We report the characteristic colocalization of 2 types of placental fibrinoid deposition and FGL2 immunoreactivity and, therefore, help in elucidating the mechanisms in the pathology of PE with FGR.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Napsin-A Expression in Mesonephric and Mesonephric-like Adenocarcinomas: Implications for Distinction From Clear Cell Carcinoma.","authors":"Jelena Mirkovic, Ekaterina Olkhov-Mitsel, Sharon Nofech-Mozes, Oluwole Fadare, W Glenn McCluggage","doi":"10.1097/PGP.0000000000001118","DOIUrl":"https://doi.org/10.1097/PGP.0000000000001118","url":null,"abstract":"<p><p>Mesonephric adenocarcinoma (MA) and mesonephric-like adenocarcinoma (MLA) are rare gynecological neoplasms that sometimes exhibit morphologic overlap with clear cell carcinoma (CCC), which may lead to diagnostic challenges. Napsin-A is regarded as the most specific immunohistochemical marker of CCC, but its expression in MLA and MA has not been widely investigated. This study investigated the expression of Napsin-A in a series of MAs and MLAs to determine its utility in distinguishing these neoplasms from CCC. The cohort included 32 MLAs arising in the ovary, endometrium, abdominal wall, and sigmoid mesocolon, 13 cervical MLAs, 2 ovarian mesonephric-like carcinosarcomas, and 1 cervical mesonephric carcinosarcoma, with Napsin-A immunohistochemistry performed on whole-slide tissue sections. Napsin-A staining was positive in 17 of 48 cases (35.4%), with focal granular cytoplasmic expression ranging from 1% to 40%. In all, 13/32 (40.6%) MLAs, 2/13 (15.4%) MAs, and 2/3 (66.7%) mesonephric or mesonephric-like carcinosarcomas were positive. Our results demonstrate that Napsin-A is expressed in a significant subset of MLAs and MAs. Given the morphologic and immunohistochemical overlap, this may contribute to misclassification as CCC, especially in cases with ambiguous morphology. Pathologists should be aware of this diagnostic pitfall and employ a panel of markers rather than relying on a single marker.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of Uterine Dedifferentiated Mesonephric-Like Adenocarcinoma With Comprehensive Molecular Profiling.","authors":"Elaina Daniels, David B Chapel, Douglas A Rottmann, Stephanie L Skala, Jean H Siedel, Tao Huang","doi":"10.1097/PGP.0000000000001117","DOIUrl":"https://doi.org/10.1097/PGP.0000000000001117","url":null,"abstract":"<p><p>Mesonephric-like adenocarcinoma (MLA) of the uterus is a rare, aggressive malignancy of presumed Müllerian origin that was recently included in the 2020 World Health Organization (WHO) Classification of Female Genital Tumours. MLA is challenging to diagnose given its rarity and morphologic heterogeneity. The recently published first case report of MLA that underwent dedifferentiation via TP53 mutation expands the morphologic spectrum of dedifferentiated carcinoma. In here, we describe a second case of an endometrial MLA with dedifferentiation from a 41-yr-old woman who presented with bilateral ovarian masses, peritoneal carcinomatosis, and hypercalcemia. A diagnosis of small cell carcinoma of the ovary, hypercalcemic type, was initially rendered at an outside institution from an omental biopsy, which only showed the undifferentiated component. The subsequent endometrial curettings performed at our institution showed both the MLA and undifferentiated components, each of which demonstrated distinct immunophenotype with the immunoreactivity to epithelial markers, GATA3 and TTF1 limited to the MLA component and the aberrant nuclear expression of beta catenin, global loss of expression of SMARCA4 and loss of expression of SMARCA2 limited to the undifferentiated component. Molecular studies on the undifferentiated component from the omental biopsy identified not only a mutation in KRAS, gene mutation commonly seen in MLA, but also mutations in SMARCA4 and CTNNB1. In summary, we describe a second case of dedifferentiated MLA with dedifferentiation driven by various genetic alterations, including SMARCA4 and CTNNB1 gene mutations, novel gene alterations that have never been described in dedifferentiated MLA.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of CDKN2C/CIC Null Epithelioid Leiomyosarcoma With a Low-grade Component Indistinguishable From Leiomyoma.","authors":"Nicolette Codispoti, Jin Xu, Lauren Montemorano, Elizabeth A Sadowski, David M Kushner, Paul S Weisman","doi":"10.1097/PGP.0000000000001114","DOIUrl":"https://doi.org/10.1097/PGP.0000000000001114","url":null,"abstract":"<p><p>Numerous emerging molecularly defined subtypes of uterine leiomyosarcoma (LMS) have been described in recent years. Here we report our experience with a challenging case of the recently described CDKN2C/CIC null subtype of LMS - a LMS subtype that is frequently epithelioid in appearance, is wild-type for both TP53 and RB1 and may exhibit low-grade histology that falls short of LMS. The 48-year-old patient was initially diagnosed with an epithelioid leiomyoma with a component of intravenous leiomyomatosis. Recurrence occurred 5 years later with an extensive disease burden in the abdomen and pelvis. Upon review, the lesion in the hysterectomy specimen and the recurrent tumor had similar morphology. This included (1) focal epithelioid morphology meeting current diagnostic criteria for epithelioid LMS and (2) other areas with morphology indistinguishable from leiomyoma (LM), including conventional spindle cell LM, cellular LM, and LM with bizarre nuclei. Targeted next-generation molecular analysis performed on both the original tumor in the hysterectomy specimen and the tumor from the recurrence showed the same CDKN2C/CIC null profile. This case highlights the striking intratumoral heterogeneity that is possible in CDKN2C/CIC null LMS, including areas morphologically indistinguishable from LM. Clinicopathological findings in this case, including features that may assist in recognizing this challenging LMS subtype, are discussed. We underscore the importance of early diagnosis, which can facilitate appropriate adjuvant and/or maintenance therapy that may decrease the morbidity associated with extensive debulking surgery.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microcystic Adnexal Carcinoma (MAC) and Eccrine Cutaneous Mixed Tumor (ECMT): 2 Cases of Rare HPV-independent Vulvar Cutaneous Adnexal Tumors.","authors":"Margarita Consing Gangelhoff, Josephine Harter, Virginia Kurth, Paul Weisman, Jin Xu","doi":"10.1097/PGP.0000000000001116","DOIUrl":"https://doi.org/10.1097/PGP.0000000000001116","url":null,"abstract":"<p><p>Microcystic adnexal carcinoma (MAC) and eccrine cutaneous mixed tumor (ECMT) are both cutaneous adnexal tumors that may occur in the vulvar region, but are very rare at this site. Consequently, they may not enter the differential diagnosis of vulvar lesions for gynecologic pathologists in a subspecialized practice setting. Here we report a case of MAC and a case of ECMT recently diagnosed at our institution and underscore key histologic and immunophenotypic features of each lesion that can assist in their correct identification. Both MAC and ECMT have a tubular to corded pattern of lesional cells within a desmoplastic to chondromyxoid stroma. However, MAC shows true eccrine sweat duct differentiation, characterized by 2 SOX10 negative cell layers, including an outer p63+/p40+/EMA- basal cell layer and an inner p63-/p40-/EMA+ ductal layer. The main differential diagnostic considerations for vulvar MAC include other cutaneous adnexal tumors with true eccrine sweat duct differentiation, namely syringoma and squamoid eccrine ductal carcinoma (SEDC). Conversely, ECMT is characterized by a single SOX10+ cell population without immunoreactivity for p63 or p40. The main differential diagnostic considerations for ECMT include the apocrine variant of cutaneous mixed tumor (ACMT)-the cutaneous analog of salivary gland pleomorphic adenoma-and other SOX10+ salivary gland-type neoplasms. Unlike the recently described vulvar analog of HPV-associated multiphenotypic sinonasal carcinoma, neither MAC nor ECMT are HPV-associated and both are therefore p16 negative. In summary, we report one case each of vulvar MAC and ECMT and discuss the key histologic features and ancillary testing results that can help to differentiate these lesions from their morphologic mimics.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SOX17 Expression in Mesotheliomas and Benign Mesothelial Proliferations: Implications for Differential Diagnosis With Gynecologic Carcinomas.","authors":"Natthawadee Laokulrath, Yin P Hung, Jaclyn C Watkins, Esther Oliva, Kyle M Devins","doi":"10.1097/PGP.0000000000001076","DOIUrl":"10.1097/PGP.0000000000001076","url":null,"abstract":"<p><p>SOX17 has recently emerged as a novel immunohistochemical marker for cancers of endometrial and ovarian origin with improved specificity compared with the widely used Mullerian marker PAX8. However, evaluation of SOX17 in benign and malignant peritoneal mesothelial proliferations remains limited, and these may mimic gynecologic carcinomas, particularly on small biopsies. We evaluated SOX17 and PAX8 expression in 20 benign mesothelial lesions (5 adenomatoid tumors, 5 well-differentiated papillary mesothelial tumors, and 10 peritoneal inclusion cysts) and 16 epithelioid peritoneal mesotheliomas. The 17 female and 3 male patients with benign mesothelial lesions ranged from 20 to 80 yr (median: 56.5 yr), while the 9 females and 7 males with mesothelioma ranged from 47 to 85 yr (median: 57.5 yr). SOX17 was positive in 5 (25%) benign lesions (2 adenomatoid tumors, 3 peritoneal inclusion cysts) and 2 (13%) mesotheliomas, while PAX8 stained 8 (40%) benign lesions (1 adenomatoid tumor, 1 well-differentiated papillary mesothelial tumor, 6 peritoneal inclusion cysts), and 2 (13%) mesotheliomas. Results for the 2 stains showed incomplete concordance, with agreement in 15 (75%) benign proliferations and 14 (88%) mesotheliomas. Our findings suggest that SOX17 positivity alone is insufficient to confirm a diagnosis of gynecologic carcinoma over a mesothelial proliferation and pathologists should exercise caution when these entities are diagnostic considerations.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":" ","pages":"217-221"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonsclerotic Lichen Sclerosus of Vulva: A Clinicopathologic Analysis.","authors":"Anne K Bartels, Oluwole Fadare","doi":"10.1097/PGP.0000000000001065","DOIUrl":"10.1097/PGP.0000000000001065","url":null,"abstract":"<p><p>The International Society of the Study of Vulvovaginal Diseases (ISSVD) recently defined nonsclerotic lichen sclerosus (NSLS) as a scenario wherein the clinical findings are consistent with lichen sclerosus (LS), but no microscopic evidence of dermal sclerosis is found and recognized 4 histologic subcategories. Herein, we present an institutional experience with NSLS, with an emphasis on frequency, application of the ISSVD categories in routine practice, and clinicopathologic correlation. The authors reviewed clinical and pathologic findings for consecutive vulvar biopsies in which LS was a clinical and/or pathologic consideration. Cases were classified as classical/sclerotic LS (CLS), NSLS (per ISSVD criteria), and \"unclassified,\" the latter of which were cases not classifiable as NSLS or CLS, despite a clinical impression or LS or LS being a significant clinical consideration (ie, \"clinical LS\"). In clinical LS cases, CLS and NSLS were diagnosed histologically in 61% (182/298) and 15% (44/298), respectively, whereas the remainder were histologically unclassified. The latter group was microscopically heterogeneous, devoid of a consistent pathologic profile, and generally showed absence, focality, minimality, ambiguity, or infrequency of features that would have allowed their categorization into one of the NSLS categories. Among the 4 categories for the categorizable NSLS cases, the \"lichenoid dermatitis\" pattern (61.4%) was the commonest, followed by dermal fibrosis with acanthosis (22.7%), dermal fibrosis without acanthosis (9.1%), and hypertrophic lichenoid dermatitis (6.8%). The clinical response rates to topical therapies for the NSLS and unclassified groups were 71% and 62%, respectively ( P =0.4). Our findings highlight the significance of clinicopathologic correlation in the diagnosis of NSLS. In the setting of clinical LS, some histologic evidence to support that impression is found in most cases when the ISSVD system for diagnosis and classification of biopsies is applied. However, a subset of clinical LS cases are not pathologically classifiable as either CLS or any of the NSLS categories; these display nonspecific histologic features and require future study.</p>","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":" ","pages":"210-216"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilomatrix-like High-grade Endometrioid Carcinoma of the Uterine Corpus With Excellent Response to Immune Checkpoint Inhibitor Therapy.","authors":"Namra Ajmal, Olivia Nicolais, Mark S Shahin, Lucy Ma","doi":"10.1097/PGP.0000000000001086","DOIUrl":"10.1097/PGP.0000000000001086","url":null,"abstract":"","PeriodicalId":14001,"journal":{"name":"International Journal of Gynecological Pathology","volume":" ","pages":"255-257"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}