Journal of International Medical Research最新文献

{"title":"Development and internal validation of a risk-scoring model for gastrointestinal flexible endoscope reprocessing failure: A retrospective observational study.","authors":"Liangyu Fang, Xiaoxuan Zhou, Meifeng Wu, Yinchuan Xu","doi":"10.1177/03000605261491484","DOIUrl":"10.1177/03000605261491484","url":null,"abstract":"<p><p>ObjectiveTo identify risk factors for flexible gastrointestinal endoscope reprocessing failure and develop a practical risk-scoring model for the early identification of high-risk reprocessing cycles.MethodsThis retrospective observational study, conducted from January to December 2025 at three endoscopy centers, included 2744 reprocessing cycles that adhered to WS 507-2016. Internal validation was performed using a split-sample approach, with 70% of the sample used for model derivation and 30% for validation. Predictors were selected using univariable and multivariable logistic regression and converted into an integer-based scoring system, with the optimal cutoff determined using the Youden index. Reporting followed the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis and Strengthening the Reporting of Observational Studies in Epidemiology guidelines, and the study was conducted in accordance with the Declaration of Helsinki.ResultsAmong the 2744 eligible reprocessing cycles, 682 (24.85%) exhibited reprocessing failure. Six independent predictors were identified: brushing personnel, washer-disinfector type, accessory use frequency, prior repair history, time from removal to reprocessing, and staff age. The scoring system, with a range of -2 to 18, achieved an area under the curve of 0.834 (95% confidence interval: 0.804-0.864) in the validation cohort. At a cutoff of ≥10, sensitivity was 0.725, specificity was 0.808, positive predictive value was 0.554, and negative predictive value was 0.899. Calibration was satisfactory based on the Hosmer-Lemeshow test and bootstrap analysis.ConclusionsThe internally validated scoring system enables the early identification of high-risk reprocessing cycles and may support quality improvement efforts. However, external validation is needed to assess its generalizability.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261491484"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069658","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":"Clinical features of primary intestinal follicular lymphoma: A single-center retrospective study.","authors":"Chun-Lin Ying, Tian-Qi Zhao, Qin-Xue Pu, Han-Cheng Huang, Wei Liu","doi":"10.1177/03000605261481620","DOIUrl":"10.1177/03000605261481620","url":null,"abstract":"<p><p>ObjectiveTo characterize the clinical features of primary intestinal follicular lymphoma and provide insights into its diagnosis and management.MethodsWe retrospectively analyzed the clinical, endoscopic, imaging, pathological, and long-term follow-up data of eight patients with primary intestinal follicular lymphoma who were admitted between January 2019 and August 2025.ResultsThe mean patient age was 58.13 years, and 75.00% of patients were women. Abdominal pain (62.50%) was the most common clinical manifestation, and 62.50% of patients presented with severe complications, including gastrointestinal bleeding or obstruction. Lesions were distributed across multiple intestinal segments. The most characteristic endoscopic finding was lymphoid follicle-like elevation (50.00%), which could be mistaken for a polyp. Histopathological examination showed that 62.50% of lesions were confined to the mucosa or submucosa. All specimens were positive for cluster of differentiation 20, B-cell lymphoma 2, and B-cell lymphoma 6. Asymptomatic patients were managed with a watch-and-wait strategy and had favorable outcomes, whereas patients requiring surgery because of severe complications associated with deeper infiltration had poorer outcomes.ConclusionPrimary intestinal follicular lymphoma is a rare, predominantly indolent B-cell lymphoma whose diagnosis relies on histopathological and immunohistochemical evaluation. Although outcomes in this small series were generally favorable, patients with severe complications may have poorer outcomes. Larger multicenter prospective studies incorporating genetic profiling are needed to validate these observations and further inform individualized management strategies.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261481620"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865344","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}

{"title":"Leukotrichia: A comprehensive review of follicular depigmentation.","authors":"Wimolsiri Iamsumang, Chaninan Kositkuljorn, Kanchana Leerunyakul, Nawara Sakpuwadol, Kasama Tejapira, Poonkiat Suchonwanit","doi":"10.1177/03000605261483177","DOIUrl":"10.1177/03000605261483177","url":null,"abstract":"<p><p>Leukotrichia refers to whitening or depigmentation of hair resulting from reduced or absent melanin in the hair shaft. Although often considered a cosmetic finding, it may reflect underlying alterations in follicular melanocyte biology and therefore have diagnostic, prognostic, and therapeutic relevance. The clinical spectrum includes congenital and genetic disorders, including piebaldism, Waardenburg syndrome, tuberous sclerosis complex, and pigment dilution syndromes; autoimmune and inflammatory conditions, including vitiligo and follicular vitiligo, alopecia areata, and Vogt-Koyanagi-Harada disease; nevus- and melanoma-associated immune phenomena; drug-induced changes; and postinflammatory, traumatic, laser-associated, and idiopathic types. This narrative review, based on a structured literature search of biomedical databases, summarizes current evidence on terminology, follicular biology, mechanisms, etiologic spectrum, diagnostic approach, management, and prognosis of leukotrichia. Leukotrichia is best regarded as a final manifestation of diverse mechanisms, including congenital absence of melanocytes, immune-mediated melanocyte destruction, collapse of follicular immune privilege, melanocyte stem cell depletion, functional inhibition of melanogenesis, and structural injury to the follicular pigmentary unit. In vitiligo, hair depigmentation may indicate depletion of the follicular melanocyte reservoir and has been associated with a poorer response to medical and phototherapeutic interventions. In other settings, it may reflect stable developmental absence or structural injury with limited potential for repigmentation. Management is primarily cause-directed, and hair repigmentation should be evaluated separately from surrounding skin repigmentation in both clinical practice and research. Key priorities include standardization of terminology, development of specific outcome measures, independent reporting of hair and skin responses, and identification of predictive biomarkers for restoration of follicular pigmentation.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261483177"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865287","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}

{"title":"Machine learning insights into the burden and risk factors of lower respiratory infections in East Asia (1990-2033).","authors":"Xian Su, Wu Xu, Wenwen Lv, Jinxin Zheng, Yuebin Wang, Tingting Wu, Li Sun, Huirong Hu, Yiping Liu, Yaolin Li","doi":"10.1177/03000605261467663","DOIUrl":"https://doi.org/10.1177/03000605261467663","url":null,"abstract":"<p><p>ObjectivesThis study quantified trends in the burden of lower respiratory infections from 1990 to 2023 in five East Asian countries, projected disease trajectories from 2024 to 2033 using machine learning, and identified key risk factors and their associations with the sociodemographic index.MethodsBased on the Global Burden of Disease Study (2023) estimates, we calculated the age-standardized incidence, prevalence, mortality, and disability-adjusted life year rates of lower respiratory infections for five East Asian countries. A multistage machine learning framework with Shapley additive explanations was used to screen exposure-related risk factors, and machine learning time-series models were used to project the future burden of lower respiratory infections.ResultsLower respiratory infection incidence and prevalence declined universally; however, mortality trends were heterogeneous (rising in South Korea and falling in others). China demonstrated the largest reduction in incidence. Mongolia demonstrated the steepest decline in prevalence; however, it continued to have a high burden of disability-adjusted life years in 2023. Exposure to secondhand smoke was the most important risk factor, whereas zinc/iron deficiency prevailed in low sociodemographic index settings; the lower respiratory infections burden had a nonlinear inverse association with the sociodemographic index, with population aging as a key driver. Projections demonstrated a continued decline in the overall burden of lower respiratory infections, although mortality rates were projected to increase in South Korea.ConclusionThe burden of lower respiratory infections has reduced substantially in East Asia over three decades; however, population aging has resulted in divergent mortality trends. High-sociodemographic index regions require age-responsive, integrated strategies targeting both exposure reduction and host vulnerability to sustain declines in mortality rates.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261467663"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075011","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":"Untargeted serum metabolomic profiling reveals altered choline-phospholipid and amino acid metabolism in patients receiving subcostal transversus abdominis plane block combined with general anesthesia for radical gastrectomy: A prospective comparative study.","authors":"Xiao Chen, Xinqiang Lin, Qiqi Li, Xiantu Qiu, Jiafeng Lin","doi":"10.1177/03000605261489359","DOIUrl":"https://doi.org/10.1177/03000605261489359","url":null,"abstract":"<p><p>ObjectiveThis study aimed to investigate, using clinical serum metabolomics, the effects of general anesthesia combined with transversus abdominis plane block (TAPB) on systemic metabolism in patients undergoing radical gastrectomy compared with general anesthesia alone.MethodsFifty-six patients undergoing laparoscopic-assisted radical gastrectomy for gastric cancer were assigned to a general anesthesia-only group (control group, 30 patients) and a general anesthesia combined with TAPB group (treatment group, 26 patients). Clinical serum metabolomics analyses were performed to investigate alterations in systemic metabolism between the control and treatment groups.ResultsKyoto Encyclopedia of Genes and Genomes analysis revealed that the top differential metabolic pathways between the treatment and control groups were choline metabolism in cancer, glycerophospholipid metabolism, adenosine triphosphate-binding cassette transporters, and protein digestion and absorption. In this study, altered choline metabolism in cancer and glycerophospholipid metabolism shared the same five metabolites, including 1-stearoyl-2-arachidonyl-sn-glycero-3-phosphocholine, 1-stearoyl-2-oleoyl-sn-glycerol 3-phosphocholine, phosphocholine, 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (PC (16:0/16:0)), and glycerophosphocholine. The levels of these metabolites were decreased with TAPB. General anesthesia combined with TAPB reduced choline and glycerophospholipid metabolism and may serve as a potential indicator. In addition, DL-proline, lysine, DL-glutamic acid, and glutamic acid were shared with adenosine triphosphate-binding cassette transporters and protein digestion and absorption. Their decreased levels in TAPB contributed to the beneficial effects of anesthesia.ConclusionsGeneral anesthesia combined with TAPB treatment reduced sufentanil dose and pain scores (numeric rating scale and visual analog scale) on postoperative days 1 and 3 compared with the control during laparoscopic-assisted radical gastrectomy. Furthermore, majority of the top differential metabolites were associated with indicators of anesthesia management and may have contributed to the beneficial effects of combined anesthesia. These metabolites included prostaglandins and sucrose, which may have contributed to the effects of anesthesia, including TAPB.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261489359"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069807","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":"Recurrent multiterritorial ischemic stroke with persistent moderate hypereosinophilia: A case report with focused literature review.","authors":"Yu Wang, Na Liu, Ju Zhu","doi":"10.1177/03000605261491519","DOIUrl":"10.1177/03000605261491519","url":null,"abstract":"<p><p>Persistent hypereosinophilia may be overlooked during stroke evaluation when conventional vascular risks coexist. We report the case of a man in his late 50s who had hypertension, type 2 diabetes, continued active smoking, and eight clinically apparent magnetic resonance imaging-confirmed strokes in multiple bilateral territories over 29 months. Before systemic glucocorticoid exposure, absolute eosinophil counts ranged from 1.87 to 3.23 × 10⁹/L on repeated measurements. Bone marrow morphology and flow cytometry revealed eosinophil expansion without aberrancy, and common tested clonal drivers were negative. Transthoracic echocardiography, two 24-h Holter recordings, and a bubble study identified no intracardiac source. Aortic computed tomography angiography in April 2026 demonstrated thoracic aortic atherosclerosis with calcified plaques and focal ulceration; transesophageal echocardiography and prolonged rhythm monitoring were not performed. A new left pontine infarct occurred in April 2026 while he was on oral prednisone (20 mg/day). In August 2026, after systemic glucocorticoid withdrawal despite continued inhaled budesonide/formoterol, a new right temporal infarct occurred, with an absolute eosinophil count of 2.66 × 10⁹/L. Worsening wheeze suggested possible eosinophilic airway inflammation; however, emphysema alone did not explain systemic eosinophilia, and eosinophilic granulomatosis with polyangiitis remained unproven. The available evidence favored a multifactorial interpretation; eosinophilia provides biological plausibility, whereas conventional vascular risks and an incompletely characterized thoracic aortic abnormality remain competing explanations. Persistent eosinophilia should prompt repeated etiological reassessment without inferring causality based on blood count or imaging pattern alone.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261491519"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069720","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":"Thromboelastography identifies preoperative hypercoagulability in surgical patients with high stroke risk scores: A cross-sectional study.","authors":"Haixia Tang, Wei Yu, Ningmei Liang, Bangsheng Hu","doi":"10.1177/03000605261487064","DOIUrl":"10.1177/03000605261487064","url":null,"abstract":"<p><p>AimThis study aimed to evaluate the value of thromboelastography as a complementary tool for identifying hypercoagulability in surgical patients at high risk for stroke by comparing its parameters with those of conventional coagulation tests and benchmarking them against healthy controls.MethodsTwo hundred and twenty patients at high risk for stroke and 40 healthy controls were recruited from a large central hospital in China between December 2019 and March 2022. The thromboelastography 5000 technology was used to acquire the thromboelastography parameters.ResultsPatients at high risk for stroke exhibited a more hypercoagulable state than healthy participants. Among patients at high risk for stroke, the high D-dimer group showed a significantly stronger hypercoagulable profile than the normal D-dimer group. The correlation between thromboelastography parameters and conventional coagulation tests was consistent with a hypercoagulable state in patients at high risk for stroke.ConclusionsThromboelastography may be useful for identifying a preoperative hypercoagulable state in this patient group, but further research is needed to determine whether such detection translates into improved clinical decision-making or outcomes.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261487064"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956102","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}

{"title":"Elucidating the transformative role of large language models in advancing anesthesiology education.","authors":"Yu Zhu, Daoqing Xie, Renrui Liang, Jian-Jun Yang, Xueke Du, Cheng-Mao Zhou","doi":"10.1177/03000605261483195","DOIUrl":"10.1177/03000605261483195","url":null,"abstract":"<p><p>This narrative review synthesizes evidence published from 2020 to 2026 on the implementation and educational impact of large language models in anesthesiology training, following the Scale for the Assessment of Narrative Review Articles guidelines. We outline core technical attributes of large language models and identify four validated anesthesiology-specific use cases: standardized learning resource generation, clinical scenario simulation, personalized remediation of knowledge gaps, and automated assessment tool development. Current evidence suggests that these applications improve trainee knowledge scores and reduce faculty workload. Key deployment barriers include the risk of hallucination in high-stakes anesthesia content and potential overreliance on large language models, which may impair independent clinical reasoning. We propose targeted mitigation strategies and a forward-looking research agenda for structured large language model integration. Our analysis confirms that large language models are high-value enabling tools for anesthesiology education and require intentional, guideline-aligned integration to maximize synergies.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261483195"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900698","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}

{"title":"An adjunctive dermocosmetic regimen improves clinical outcomes and tolerability in Japanese patients on topical acne therapy: A real-world observational study.","authors":"Ichiro Kurokawa, Miwa Kobayashi, Yuko Nomura, Masatoshi Abe, Xuebing Li","doi":"10.1177/03000605261479490","DOIUrl":"10.1177/03000605261479490","url":null,"abstract":"<p><p>ObjectiveA real-world observational study was conducted to evaluate the effectiveness, safety, and tolerability of an adjunctive dermocosmetic regimen in topical acne therapy.MethodsFifty Japanese patients who had been undergoing topical prescription treatment for >4 weeks adjunctively used two dermocosmetic products, a facial cleanser and moisturizer cream for 3 months.ResultsThe Global Evaluation Acne scale score, sebum production, skin findings, subjective symptoms, and patient quality of life were significantly improved after 3 months dermocosmetics of use. Tolerability for the dermocosmetics use was rated as \"well-tolerated\" or \"tolerated\" by 75.5% of physicians and 73.5% of patients. Satisfaction with dermocosmetics use was high, with 87.5% of physicians and 92.0% of patients rating their satisfaction level as \"very satisfied\" or \"satisfied.\" Most patients (86.0%) agreed or strongly agreed that they preferred using the study dermocosmetics over their previous cosmetics. Furthermore, 70.0% and 72.0% of the patients agreed that the dermocosmetic facial cleanser and moisturizing cream, respectively, improved the tolerability of their acne treatment.ConclusionsThese findings suggest that the dermocosmetic regimen involving the use of a facial cleanser and moisturizing cream, when used in combination with topical prescription drugs is beneficial, well-tolerated, and acceptable among patients for the treatment of acne in real-world routine clinical practice in Japan.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261479490"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900716","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}

{"title":"Prognostic value and immune landscape implications of using a novel homologous recombination repair pathway signature in prostate cancer: A retrospective cohort study.","authors":"Feng Wang, Y E Tian, Qin Liu, M O Sha, Peng Wang, XueLiang Huang, Kuerban Tuoheti, Jun Chen, Q I Cui","doi":"10.1177/03000605261487253","DOIUrl":"https://doi.org/10.1177/03000605261487253","url":null,"abstract":"<p><p>ObjectiveAlthough the homologous recombination repair (HRR) pathway plays a critical role in the treatment of prostate cancer, its prognostic value remains incompletely understood. This study aimed to identify HRR pathway-related biomarkers with clinical utility for prognosis prediction and treatment guidance.MethodsWe analyzed genomic data from The Cancer Genome Atlas and Chinese patients with prostate cancer in a retrospective cohort study using a comprehensive multiomics approach to characterize a novel HRR-related prognostic signature and its immune implications.ResultsIn the Chinese cohort, 25.6% of the patients exhibited homologous recombination deficiency scores >42, whereas 27.3% carried ≥1 HRR gene mutation. We established a prognostic HRR signature (homologous recombination deficiency score >32, HRR gene mutations, and Signature 3) associated with poor outcomes. Compared with The Cancer Genome Atlas data, the Chinese cohort demonstrated a higher prevalence of HRR signature. Patients with HRR signatures demonstrated significantly increased genomic instability markers, including segment number, alteration burden, aneuploidy score, and intratumor heterogeneity. The HRR signature was associated with higher neoantigen load but reduced T cell receptor (TCR) evenness. Immunologically, HRR-positive tumors were associated with computationally inferred immune profiles suggestive of reduced immune activity, characterized by depletion of T-helper 17 cell; downregulation of <i>TLR4</i>/<i>PDCD1LG2</i> expression; and upregulation of <i>ARG1</i>, <i>IFNG</i>, <i>KIR2DL3</i>, and <i>CXCL9</i>. However, these findings are descriptive and require experimental validation.ConclusionOur findings identify a clinically relevant HRR signature that warrants investigation as a potential predictive biomarker for prostate cancer prognosis and treatment response. This biomarker provides new insights for personalized therapy and may help optimize patient outcomes.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":"54 9","pages":"3000605261487253"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990287","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}