International Journal of Gynecological Cancer最新文献

{"title":"Suggestion of new algorithm to simplify pelvic exenteration.","authors":"Cagatay Taskiran, Burak Giray, Emin Erhan Donmez, Tonguc Arslan, Dogan Vatansever, Macit Arvas","doi":"10.1016/j.ijgc.2024.101614","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.101614","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"101614"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457880","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":"Laparoscopic bariatric surgery with hysterectomy for endometrial cancer to improve long-term outcomes: A review article.","authors":"Emma Goddard, David Pace, Laurie Twells, Joannie Neveu","doi":"10.1016/j.ijgc.2024.100033","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.100033","url":null,"abstract":"<p><p>Endometrial cancer is the most common gynecologic malignant disease in Canada, and women with an elevated body mass index carry an increased lifetime risk of developing this disease. As rates of obesity have risen, the rates of endometrial cancer have seen a similar rise. Given this association, women diagnosed with endometrial cancer often suffer from several obesity-related co-morbidities, including type 2 diabetes, hypertension, and cardiovascular disease. Studies have suggested that women with early-stage endometrial cancer have a higher potential to die of obesity-related complications than recurrence and that weight reduction would be beneficial for these patients to improve quality-of-life and long-term obesity-related morbidity and mortality. Bariatric surgery is currently the only treatment modality to result in sustained long-term weight loss for this cohort of patients. Early evidence has suggested that combining bariatric surgery with total laparoscopic hysterectomy may improve the underlying metabolic disease, the patients' quality of life, and the long-term obesity-related morbidity and mortality. Additionally, the inclusion of bariatric surgery in treatment of patients with obesity and endometrial cancer may decrease the projected lifetime health care cost when compared to hysterectomy alone. This narrative review aims to examine the evidence surrounding endometrial cancer and its link to obesity. Further, we hope to explore current treatments for the aforementioned conditions and the possible benefits and feasibility of a combined intervention of vertical sleeve gastrectomy and total laparoscopic hysterectomy for patients with obesity and endometrial cancer.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"100033"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457958","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 and microenvironmental landscapes of human papillomavirus-independent invasive squamous cell carcinoma of the vulva.","authors":"Sara Moufarrij, Olga Filippova, Arnaud Da Cruz Paula, Juan Blanco Heredia, Hunter Green, Vance Broach, Mario M Leitao, Roisin E O'Cearbhaill, Nadeem R Abu-Rustum, Kay J Park, Britta Weigelt, Dmitriy Zamarin","doi":"10.1016/j.ijgc.2024.100051","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.100051","url":null,"abstract":"<p><strong>Objective: </strong>Human papillomavirus (HPV)-independent vulvar squamous cell carcinoma has a worse prognosis compared to its HPV-associated counterpart. We sought to characterize the mutational landscape and the tumor microenvironment of HPV-independent vulvar cancer.</p><p><strong>Methods: </strong>Primary, untreated vulvar cancers with known HPV-independent vulvar cancer or without definitive HPV association between 2006 and 2016 were identified. Pathology re-review, p16 immunohistochemistry, and HPV 16 and 18 polymerase chain reaction were performed to determine HPV status. HPV-independent vulvar cancers underwent targeted tumor-normal panel sequencing and NanoString gene expression analysis. Multiplex immunofluorescence analysis for CD8, programmed cell death protein-1, and PD-L1 was performed for HPV-independent and HPV-associated vulvar squamous cell carcinomas.</p><p><strong>Results: </strong>Of the 93 vulvar squamous cell carcinomas identified, 19 were HPV-independent. Targeted sequencing revealed recurrent somatic mutations affecting TP53 (13/19, 68%), FAT1 (6/19, 32%), NOTCH1 (5/19, 26%), and CDKN2A (5/19, 26%). Five (26%) of the 19 cases had a dominant apolipoprotein B mRNA-editing enzyme, catalytic polypeptide-related mutational signature, whereas the remaining had dominant clock/aging-related mutational signatures. Expression of genes related to immune response including the chemokine CXCL8 and HLA-DRB5 were found to be significantly higher in primary HPV-independent vulvar squamous cell carcinomas that did not recur compared to those with subsequent recurrence (p = .02). Multiplex immunofluorescence analysis revealed that HPV-independent vulvar squamous cell carcinomas were characterized by tumor infiltration with CD8+programmed cell death protein-1+ T cells and their interaction with CD68+PD-L1+ macrophages.</p><p><strong>Conclusions: </strong>HPV-independent vulvar squamous cell carcinoma is a heterogeneous disease with mutations affecting cell cycle-related genes, apolipoprotein B mRNA-editing enzyme, catalytic polypeptide and clock-like mutational signatures, and evidence of an immune-active tumor microenvironment in primary tumors. Our data provide the basis for exploration of immune biomarkers and therapeutics in this disease.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"100051"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457966","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":"Reply to \"Correspondence on 'Fertility-sparing treatment with conization versus radical hysterectomy in patients with early-stage cervical cancer: Inverse propensity score-weighted analysis,' by Ditto et al\" by Phillippe Morice and Sebastien Gouy.","authors":"Antonino Ditto, Marco Dri, Umberto Leone Roberti Maggiore, Francesco Raspagliesi","doi":"10.1016/j.ijgc.2024.100026","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.100026","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"100026"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457871","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":"Epithelial ovarian cancer and borderline tumors during pregnancy: a report from the International Network on Cancer, Infertility, and Pregnancy.","authors":"Robert Fruscio, Rita Trozzi, Stefania Galimberti, Charlotte LeJeune, Kristel Van Calsteren, Martina Delle Marchette, Elyce Cardonick, Floriana Mascilini, Michael Halaska, Inge Peters, Anna Fagotti, Frederic Amant","doi":"10.1016/j.ijgc.2024.100053","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.100053","url":null,"abstract":"<p><strong>Objective: </strong>To describe the oncological and obstetrical outcomes of women diagnosed with borderline ovarian tumors or epithelial ovarian cancer during pregnancy.</p><p><strong>Methods: </strong>This is an international retrospective cohort study. Patients were eligible for inclusion if they were diagnosed with borderline tumor or invasive ovarian cancer during pregnancy, with histologic confirmation either before or after delivery, and were registered in the International Network on Cancer, Infertility and Pregnancy database between 1982 and 2019.</p><p><strong>Results: </strong>A total of 129 patients were included, of whom 69 (53%) with borderline and 60 (47%) with invasive cancer. Diagnosis was established in the first, second, and third trimesters in 59 (46%), 48 (37%), and 22 (17%) patients, respectively. In total, 47 (36%) patients did not receive any treatment during pregnancy. The majority of patients (64%) underwent surgery with or without chemotherapy during pregnancy. Birthweight was significantly lower in women who received chemotherapy during pregnancy as compared to those who did not (median birthweight 2528 g vs 3031 g, p = .01) Among patients with borderline tumors, 20 (29%) experienced a relapse of whom 2 subsequently died from the disease. The 5-year survival probability was 98.5% (95% CI 95.6 to 100). Recurrence was associated with incomplete surgical staging (p = .02). Among patients with epithelial ovarian cancer, the relapse rate was 25% and the 5-year survival probability was 83.6% (95% CI 74.3 to 94.1). The oncological outcome was worse for patients with advanced-stage disease (p = .03). In addition, 66% of patients who relapsed after pregnancy did not undergo adequate surgical staging.</p><p><strong>Conclusions: </strong>Treatment of patients with ovarian cancer during pregnancy can result in favorable oncological and obstetrical outcomes. Better oncological outcomes are achieved when treatment adheres to the standard of care in non-pregnant patients, as those who did not undergo surgical staging experienced a higher relapse rate.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"100053"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457954","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":"Perspectives on inclusion, diversity, equity, and access in clinical trials: findings from a 6-continent survey.","authors":"Desislava Dimitrova, Jolijn Boer, Murat Karaman, Michael Bookman, Alison Brand, Jennifer O'Donnell, Amit Oza, Bhavana Pothuri, Katherine Bennett, Jalid Sehouli","doi":"10.1016/j.ijgc.2024.101625","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.101625","url":null,"abstract":"<p><strong>Objective: </strong>Clinical trials require the inclusion of all relevant demographic groups, including under-represented populations, to ensure accurate and representative findings. The aim of the study was to assess the status quo of inclusion, diversity, equity, and access in clinical trials across various countries.</p><p><strong>Methods: </strong>An 18-item online survey was developed and administered to 5 people. The questionnaire was distributed to delegates from gynecologic research groups in the Gynecologic Cancer Intergroup Network worldwide. All the analyses are purely descriptive.</p><p><strong>Results: </strong>A total of 73 participants (86.3% physicians and 47.9% female) from 33 countries participated in the survey; 91.8% deemed the inclusion of under-represented groups in clinical trials important, and 91.2% supported increasing representation in phase III trials. Most participants believed that language barriers (68.7%) and restricted eligibility criteria (56.7%) were the main reasons for under-representation. Language barriers are seen as more significant in Africa and Europe than in Asia (83.3% and 75.0% vs 58.6%, respectively). Limited patient knowledge about clinical trials (73.1%) was also cited as a key issue. Only 20.5% reported having a minimal data set to document demographic groups. The most helpful measure was the provision of trial information in various languages (69.7%). Overall, women were more supportive of all the suggested improvement measures than were men.</p><p><strong>Conclusions: </strong>There is a need for better strategies to improve diversity in clinical trials, focusing on overcoming language barriers and eligibility constraints.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"101625"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457707","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":"BRCA mutation testing and association with oncologic outcome and incidence of ovarian cancer in Norway.","authors":"Alda Birgisdóttir, Tor Åge Myklebust, Merete Bjørnslett, Vibeke W Rognlien, Torbjorn Paulsen, Anne Dørum","doi":"10.1016/j.ijgc.2024.100029","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.100029","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the frequency of BRCA mutations and testing, age at diagnosis, and incidence of ovarian cancer and to describe oncologic outcomes in patients carrying BRCA mutation compared with those not carrying mutation, in 1 cancer center that covers two-thirds of the Norwegian population.</p><p><strong>Methods: </strong>Patients with ovarian cancer treated at Oslo University Hospital-Radiumhospital 2008-2019 who accepted BRCA testing were prospectively registered in the study. Patients carrying mutation and their families received genetic counseling and risk-reducing surgery. For patients treated from 2014 to 2019 (N = 1032), detailed clinicopathologic data (International Federation of Gynecology and Obstetrics stage, histopathology, type of surgery, residual disease, chemotherapy, first recurrence, and survival) were obtained. Overall and progression-free survival were analyzed using Kaplan-Meier curves and Cox regressions. Linear trends were assessed using linear regressions. Using data delivered by the Cancer Registry of Norway, we assessed ovarian cancer incidence in the uptake area of Oslo University Hospital-Radiumhospital throughout the study period.</p><p><strong>Results: </strong>A total of 1579 patients were registered. Throughout the study period, BRCA mutation frequency was decreasing, from 14.5% to 6.8%, and mean age at diagnosis increasing, from 59.4 to 63.8 years, in 2008 and 2019, respectively. Patients carrying BRCA1 mutation were younger at diagnosis than were patients carrying BRCA2 mutation and those not carrying mutation. Patients carrying BRCA mutation had almost exclusively high-grade serous histology, and had more often advanced disease and higher cancer antigen 125 levels at the time of diagnosis and were more often treated with interval debulking surgery than were those not carrying mutation. Patients carrying BRCA2 mutation had better overall survival than did those not carrying mutation. The incidence rate of ovarian cancer was decreasing throughout the study, from 22 to 18 per 100,000 person-years in 2008 and 2019, respectively.</p><p><strong>Conclusion: </strong>BRCA mutation testing in patients with ovarian cancer has become more widely incorporated into clinical practice over time, owing to its importance for prognosis and for risk-reducing measures in the families of patients carrying mutation, and possibly contributes to a decrease in ovarian cancer incidence.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"100029"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457904","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":"Extra-gonadal granulosa cell tumor mimicking inferior vena cava sarcoma.","authors":"Pradyumna R Sasithota, Abhay K Kattepur","doi":"10.1016/j.ijgc.2024.100061","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.100061","url":null,"abstract":"","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"100061"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457956","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":"Probe-based confocal laser endomicroscopy intra-operative evaluation in ovarian cancer: definition of in vivo architectural patterns to determine resection strategies.","authors":"Paola Spessotto, Nicolò Clemente, Maurizio Mongiat, Alessandra Capuano, Gustavo Baldassarre, Jerry Polesel, Anna Del Fabro, Emilio Lucia, Stefano Realdon, Stefania Maiero, Vincenzo Canzonieri, Giorgio Giorda, Renato Cannizzaro, Antonino Ditto","doi":"10.1016/j.ijgc.2024.101626","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.101626","url":null,"abstract":"<p><strong>Objective: </strong>Probe-based confocal laser endomicroscopy (pCLE) is a novel real-time imaging technique that is potentially useful for accurately distinguishing between normal and cancerous tissues. The aim of this study was to describe the pCLE patterns of areas suggestive of tumors and evaluate the ability of the method to differentiate between normal and cancerous tissue during cytoreductive surgery for epithelial ovarian cancer.</p><p><strong>Methods: </strong>In vivo pCLE images and subsequent biopsies were acquired from various anatomical sites including the parietal and visceral peritoneum, ovaries, and omentum. Each endomicroscopic sequence was analyzed by highly experienced investigators using pCLE imaging for cancer diagnosis. Each pCLE sequence was compared with the histology of the corresponding specimens.</p><p><strong>Results: </strong>We enrolled 18 women with International Federation of Gynecology and Obstetrics stage III/IV high-grade serous epithelial ovarian cancer referred for primary or interval debulking surgery. A total of 112 biopsies were obtained for histologic analysis. The pCLE images of normal tissue showed a regular distribution of stromal fibers and consistent cellular architecture, regardless of the anatomical region, with vascularized areas characterized by regular vessels. Conversely, the extravasation of fluorescein, used as a contrast agent, was a distinguishing feature of malignant nodules, which were easily recognized by leakage and are typical of tumor-associated vessels. The leakage often surrounded the dark clusters of neoplastic cells. A substantial agreement between pCLE and histology emerged (k = 0.66), whereas only a fair concordance between the surgeon's intra-operative assessment and histology was found (k = 0.30).</p><p><strong>Conclusions: </strong>Our results suggest that pCLE is a promising intra-operative technique to assist surgeons in accurately detecting peritoneal metastases in patients with advanced epithelial ovarian cancer, enhancing surgical radicality while avoiding unnecessary resection.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"101626"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449043","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":"Pre-operative impact of multimodal prehabilitation in gynecologic oncology patients.","authors":"Ester Miralpeix, Cristina Rodriguez-Cosmen, Berta Fabregó, Josep-Maria Sole-Sedeno, Jesus Carazo, Marc Sadurní, Marta Corcoy, Gemma Mancebo","doi":"10.1016/j.ijgc.2024.100062","DOIUrl":"https://doi.org/10.1016/j.ijgc.2024.100062","url":null,"abstract":"<p><strong>Objective: </strong>Multimodal prehabilitation is a multi-disciplinary program that includes exercise, nutrition, and psychological intervention before surgery to improve pre-operative functional capacity. This study aims to assess the impact of a prehabilitation program on the pre-operative functional status of gynecologic oncology patients.</p><p><strong>Methods: </strong>This single-center, prospective observational study included all consecutive patients diagnosed with gynecologic cancer who were scheduled for surgery and enrolled in a structured prehabilitation program from January 2018 to May 2024. Only patients with both baseline and pre-operative evaluations were included. Functional status data were compared before (baseline) and after (pre-operative) the prehabilitation intervention. The primary outcome measured was functional capacity, as determined by the 6-minute walk test (6MWT). Secondary outcomes included hand grip strength, the Malnutrition Universal Screening Tool (MUST) score, and the Hospital Anxiety and Depression Scale score. The type of training and adherence were also evaluated.</p><p><strong>Results: </strong>A total of 77 patients underwent both baseline and pre-operative evaluation at the prehabilitation unit. The median duration of the program was 25.2 days (range; 9-63). Significant pre-operative improvements were observed in 6MWT (baseline: 435.7 m, standard deviation [SD] = 115.9 vs pre-operative: 455.7 m, SD = 118.9, p < .001), hand grip strength (baseline: 19.0 kg, SD = 5.5 vs pre-operative: 20.4 kg, SD = 5.9, p = .012), MUST score (baseline MUST ≥2 in 14.3% patients vs pre-operative 3.9%, p = .03), and Hospital Anxiety and Depression Scale score (baseline anxiety score: 7.4, SD = 4.3 vs pre-operative: 6.3, SD = 3.6, p < .001; and baseline depression score: 5.5, SD = 4.2 vs pre-operative: 4.3, SD = 3.6, p < .001). Among the different training programs, patients participating in supervised CrossFit training showed greater improvement in the 6MWT (33.4 m), compared to the hospital-supervised group (27.1 m), and the non-supervised home training group (14.0 m).</p><p><strong>Conclusions: </strong>A structured multimodal prehabilitation program improves pre-operative functional capacity in gynecologic oncology patients, with the greatest improvements seen in those who participated in supervised high-intensity training, such as CrossFit.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"100062"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457709","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}