Liver Cancer最新文献

{"title":"Lenvatinib plus Pembrolizumab Combined with Transarterial Chemoembolization in Intermediate-Stage Hepatocellular Carcinoma.","authors":"Masatoshi Kudo","doi":"10.1159/000543245","DOIUrl":"10.1159/000543245","url":null,"abstract":"","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 1","pages":"1-7"},"PeriodicalIF":11.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in Adjuvant Immunotherapy after Resection or Ablation for Hepatocellular Carcinoma at High-Risk of Recurrence.","authors":"Masatoshi Kudo","doi":"10.1159/000542221","DOIUrl":"10.1159/000542221","url":null,"abstract":"","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"13 6","pages":"573-578"},"PeriodicalIF":11.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic Peripheral T-Cell Analysis Identifies On-Treatment Prognostic Biomarkers of Atezolizumab plus Bevacizumab in Hepatocellular Carcinoma.","authors":"Ji Won Han, Min Woo Kang, Soon Kyu Lee, Hyun Yang, Ji Hoon Kim, Jae-Sung Yoo, Hee Sun Cho, Eun Ji Jang, Deok Hwa Seo, Jung Hyun Kwon, Soon Woo Nam, Si Hyun Bae, Jeong Won Jang, Jong Young Choi, Seung Kew Yoon, Pil Soo Sung","doi":"10.1159/000541181","DOIUrl":"10.1159/000541181","url":null,"abstract":"<p><strong>Introduction: </strong>Variability in response to atezolizumab plus bevacizumab (AB) treatment of hepatocellular carcinoma (HCC) underscores the critical need for the development of effective biomarkers. We sought to identify peripheral blood biomarkers reflecting response to AB treatment.</p><p><strong>Methods: </strong>We analyzed dynamic changes in peripheral blood mononuclear cells from a prospective, multicenter cohort of 65 patients with HCC, using flow cytometry to evaluate the T-cell population before and 3 weeks after the first AB treatment.</p><p><strong>Results: </strong>We found a unique response of the CD8⁺ T cells in terms of both frequency and phenotype, in contrast to CD4⁺ T cells and regulatory T cells. Notably, CD8⁺ T cells showed significant changes in expression of Ki-67 and T-cell immunoreceptors with Ig and ITIM domains (TIGIT). These distinct responses were observed particularly in the programmed cell death receptor-1 (PD-1)⁺ subpopulation of CD8⁺ T cells. Interestingly, the baseline differentiation status of PD-1⁺CD8⁺ T cells, particularly the central memory T-cell subset, correlated positively with greater proliferation (higher Ki-67 expression) of PD-1⁺CD8⁺ T cells after treatment. Moreover, effector memory cells expressing CD45RA correlated negatively with the increase in TIGIT⁺/PD-1⁺CD8⁺ T cells. The increase in TIGIT⁺/CD8⁺ T cells was associated with the development of immune-related adverse events, whereas increase in Ki-67⁺/PD-1⁺CD8⁺ T cells was associated with the better objective response rate. Importantly, dynamic shifts of Ki-67⁺/PD-1⁺CD8⁺ T cells and TIGIT⁺/CD8⁺ T cells significantly predicted progression-free survival and overall survival, as confirmed by multivariate analysis.</p><p><strong>Conclusion: </strong>These findings highlight the potential of dynamic changes in CD8⁺ T cells as an on-treatment prognostic biomarker. Our study underscores the value of peripheral blood profiling as a noninvasive and practical method for predicting the clinical outcomes of AB treatment in patients with HCC.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 1","pages":"104-116"},"PeriodicalIF":11.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Normal Hepatobiliary Cell Zonation Programs on the Phenotypes and Functions of Primary Liver Tumors.","authors":"Tomoko Aoki, Naoshi Nishida, Yasunori Minami, Masatoshi Kudo","doi":"10.1159/000541077","DOIUrl":"10.1159/000541077","url":null,"abstract":"<p><strong>Background: </strong>Traditional tumor classifications have relied on cellular origin, pathological morphological features, gene expression profiles, and more recently, the tumor immune microenvironment. While these classifications provide valuable insights, incorporating physiological classifications focusing on liver metabolic functions may lead to new discoveries.</p><p><strong>Summary: </strong>We proposed to reclassify benign and malignant hepatocellular neoplasms based on their physiological functions such as albumin production, bile acid production, glycolysis, glycogenesis, and adipogenesis. We further demonstrated the homology between signal pathways activated by the differentiation program of the normal hepatobiliary cells and those activated by genetic abnormalities in tumors. Specifically, Wnt/β-catenin, RAS, NOTCH, and TGF-β signaling not only contribute to cell differentiation via activation of liver-enriched transcription factors but also determine the tumor traits. Examining the distinctions between hepatocellular carcinomas (HCCs) that maintain or lose metabolic functions can yield valuable insights into the drivers of biological malignancy and tumor plasticity.</p><p><strong>Key messages: </strong>To confirm the homology between the differentiation programs of normal hepatobiliary cells, hepatocellular adenomas (HCA), and HCC we identify liver-specific functions such as catabolism and anabolism within tumors. HCCs and HCAs that have lost these metabolic functions exhibit characteristics such as dedifferentiation, resemblance to biliary cells, or increased glycolysis. Focusing on this underexplored area will likely stimulate active research into new tumor characteristics.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 1","pages":"92-103"},"PeriodicalIF":11.6,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Diabetes Mellitus and Obesity Comorbidities on Survival Outcomes after Hepatocellular Carcinoma Resection: A Multicenter Retrospective Study.","authors":"Hiroji Shinkawa, Masaki Kaibori, Masaki Ueno, Satoshi Yasuda, Hisashi Ikoma, Tsukasa Aihara, Takuya Nakai, Masahiko Kinoshita, Hisashi Kosaka, Shinya Hayami, Yasuko Matsuo, Ryo Morimura, Takayoshi Nakajima, Chihoko Nobori, Takeaki Ishizawa","doi":"10.1159/000540858","DOIUrl":"10.1159/000540858","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the association of obesity and diabetes mellitus (DM) comorbidity with hepatocellular carcinoma (HCC) recurrence and survival.</p><p><strong>Methods: </strong>We investigated 1,644 patients who underwent hepatic resection for solitary HCC without vascular invasion using computed tomography. Patients were categorized into four groups according to the combination of obesity and DM comorbidities: OB (+) or (-) and DM (+) or (-). Postoperative cumulative recurrence rates within and beyond 2 years and beyond 5 years were assessed.</p><p><strong>Results: </strong>Multivariate Cox proportional hazard regression analysis revealed that the adjusted hazard ratios (HRs) of reduced recurrence-free survival was 1.10 (95% confidence interval [CI]: 0.91-1.33; <i>p</i> = 0.31), 0.94 (95% CI: 0.78-1.12; <i>p</i> = 0.48), and 1.24 (95% CI: 1.01-1.54; <i>p</i> = 0.045) in the OB(+)DM(-), OB(-)DM(+), and OB(+)DM(+) groups compared with the OB(-)DM(-) group, respectively. Additionally, the corresponding adjusted HRs of reduced overall survival were 0.93 (<i>p</i> = 0.57), 0.97 (<i>p</i> = 0.76), and 1.38 (<i>p</i> = 0.013) for OB(+)DM(-), OB(-)DM(+), and OB(+)DM(+) groups, respectively. No significant difference in the early recurrence rate was determined among the four groups. The OB(+)DM(+) group demonstrated an increased risk for late recurrence beyond 2 years and 5 years postoperatively compared with the OB(-)DM(-) group (HR: 1.51; <i>p</i> = 0.024 and HR: 2.53; <i>p</i> = 0.046, respectively). The OB(+)DM(-) and OB(-)DM(+) groups demonstrated an increased risk for late recurrence beyond 5 years postoperatively (HR: 3.83; <i>p</i> < 0.001 and HR: 1.95; <i>p</i> = 0.037, respectively).</p><p><strong>Conclusions: </strong>Obesity and DM coexistence increased late recurrence and worsened prognosis in patients with HCC undergoing hepatic resection. The results help surgeons develop possible different surveillance protocol and need to focus on diabetes/obesity control during life-long surveillance for patients with HCC.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 1","pages":"80-91"},"PeriodicalIF":11.6,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"M2BPGi Correlated with Immunological Biomarkers and Further Stratified Recurrence Risk in Patients with Hepatocellular Carcinoma.","authors":"I-Cheng Lee, Hao-Jan Lei, Lei-Chi Wang, Yi-Chen Yeh, Gar-Yang Chau, Cheng-Yuan Hsia, Shu-Cheng Chou, Jiing-Chyuan Luo, Ming-Chih Hou, Yi-Hsiang Huang","doi":"10.1159/000540802","DOIUrl":"10.1159/000540802","url":null,"abstract":"<p><strong>Introduction: </strong>Novel biomarkers reflecting liver fibrosis and the immune microenvironment may correlate with the risk of hepatocellular carcinoma (HCC) recurrence. This study aimed to evaluate the prognostic value of serum biomarkers in predicting HCC recurrence.</p><p><strong>Methods: </strong>Serum biomarkers, including M2BPGi, IL-6, IL-10, CCL5, VEGF-A, soluble PD-1, PD-L1, TIM-3, and LAG-3, were measured in 247 patients with HCC undergoing surgical resection. Factors associated with recurrence-free survival (RFS) and overall survival (OS) were evaluated. The ERASL-post model and IMbrave050 criteria were used to define HCC recurrence risk groups.</p><p><strong>Results: </strong>Serum M2BPGi levels significantly correlated with FIB-4 score, aspartate transaminase-to-platelet ratio index, ALBI score, alpha-fetoprotein (AFP), alanine transaminase, aspartate transaminase, IL-10, CCL5, VEGF-A, soluble PD-1, PD-L1, TIM-3, and LAG-3 levels. M2BPGi, VEGF-A, soluble PD-1, and TIM-3 levels significantly correlated with RFS. In multivariate analysis, M2BPGi >1.5 COI (hazard ratio [HR] = 2.100, <i>p</i> < 0.001), tumor size >5 cm (HR = 1.859, <i>p</i> = 0.002), multiple tumors (HR = 2.562, <i>p</i> < 0.001), AFP >20 ng/mL (HR = 2.141, <i>p</i> < 0.001), and microvascular invasion (HR = 1.954, <i>p</i> = 0.004) were independent predictors of RFS. M2BPGi levels significantly stratified the recurrence risk in ERASL-post and IMbrave050 risk groups. An M2BPGi-based model could significantly discriminate RFS in the overall cohort as well as in the IMbrave050 low- and high-risk groups. M2BPGi >1.5 COI was also an independent predictor of OS after resection (HR = 2.707, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Serum M2BPGi levels significantly correlated with surrogate markers of liver fibrosis, liver function, and immunology. M2BPGi is a significant predictor of HCC recurrence and survival after resection and could be incorporated into recurrence-prediction models.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 1","pages":"68-79"},"PeriodicalIF":11.6,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nivolumab plus Ipilimumab: A Novel First-Line Combination Immunotherapy for Unresectable Hepatocellular Carcinoma.","authors":"Masatoshi Kudo","doi":"10.1159/000540801","DOIUrl":"10.1159/000540801","url":null,"abstract":"","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"13 5","pages":"459-467"},"PeriodicalIF":11.6,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of TP53-Induced Glycolysis and Apoptosis Regulator on Prognosis in Hepatocellular Carcinoma: Association with Tumor Microenvironment and Ferroptosis.","authors":"Katsuya Toshida, Shinji Itoh, Norifumi Iseda, Shugo Tanaka, Kensuke Nakazono, Takahiro Tomiyama, Shohei Yoshiya, Takeo Toshima, Noboru Harada, Kenichi Kohashi, Koji Taniguchi, Yoshinao Oda, Tomoharu Yoshizumi","doi":"10.1159/000540180","DOIUrl":"10.1159/000540180","url":null,"abstract":"<p><strong>Introduction: </strong><i>TP53</i>-induced glycolysis and apoptosis regulator (TIGAR) is a p53 target protein that has critical roles in glycolysis and redox balance. The reports about the effect of TIGAR on prognosis and its biological role in hepatocellular carcinoma (HCC) are limited.</p><p><strong>Methods: </strong>A total of 386 patients with HCC who had undergone hepatic resection were enrolled. Immunohistochemical staining for TIGAR was performed. Additionally, the regulation of malignant activity and ferroptosis by TIGAR was investigated in vitro.</p><p><strong>Results: </strong>Patients were divided into TIGAR-positive (<i>n</i> = 80, 20.7%) and -negative (<i>n</i> = 306, 79.3%) groups. TIGAR positivity was significantly correlated with lower albumin, higher α-fetoprotein/ <i>des</i>-gamma-carboxyprothrombin, larger tumor size/number of tumors, and greater proportions of BCLC staging C/single nodular type/poor differentiation/microscopic vascular invasion/microscopic intrahepatic metastasis. In multivariate analysis, TIGAR positivity was an independent prognostic factor (<i>p</i> < 0.0001). In addition, TIGAR positivity was significantly associated with a smaller number of cluster of differentiation (CD) 8-positive T cells (<i>p</i> = 0.0450), larger number of CD68-positive macrophages (<i>p</i> = 0.0058), larger number of programmed death-ligand 1-positive cases (<i>p</i> = 0.0002), and larger number of vessels that encapsulate tumor cluster-positive cases (<i>p</i> = 0.0004). In vitro, <i>TIGAR</i> knockdown decreased cell motility and induced ferroptosis. <i>TIGAR</i> knockdown inhibited the phosphorylation of adenosine monophosphate-activated protein kinase and acetyl-CoA carboxylase. Ferroptosis induced by <i>TIGAR</i> knockdown was inhibited by liproxstatin and baicalein treatment. The combination of <i>TIGAR</i> knockdown and lenvatinib further induced ferroptosis.</p><p><strong>Conclusion: </strong>High expression of TIGAR impacted the clinical outcome of HCC patients and TIGAR was associated not only with tumor microenvironment but also with resistance to ferroptosis.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"14 1","pages":"36-57"},"PeriodicalIF":11.6,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.1159/000540463","DOIUrl":"https://doi.org/10.1159/000540463","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1159/000537947.].</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"13 5","pages":"572"},"PeriodicalIF":11.6,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Atezolizumab plus Bevacizumab versus Sorafenib in Hepatocellular Carcinoma with Main Trunk and/or Contralateral Portal Vein Invasion in IMbrave150.","authors":"Richard S Finn, Peter R Galle, Michel Ducreux, Ann-Lii Cheng, Norelle Reilly, Alan Nicholas, Sairy Hernandez, Ning Ma, Philippe Merle, Riad Salem, Daneng Li, Valeriy Breder","doi":"10.1159/000539897","DOIUrl":"10.1159/000539897","url":null,"abstract":"<p><strong>Introduction: </strong>Atezolizumab plus bevacizumab significantly improved overall survival (OS) and progression-free survival (PFS) versus sorafenib in patients with unresectable hepatocellular carcinoma (HCC) in IMbrave150. Efficacy and safety in patient subpopulations with Vp4 portal vein tumor thrombosis (PVTT) and other high-risk prognostic factors are reported.</p><p><strong>Methods: </strong>IMbrave150 was a global, randomized (2:1), open-label, phase 3 study in systemic treatment-naive patients with unresectable HCC; OS and PFS were co-primary endpoints. Exploratory analyses compared the efficacy and safety of atezolizumab 1,200 mg plus bevacizumab 15 mg/kg every 3 weeks versus sorafenib 400 mg twice daily in patients (i) with and without Vp4 PVTT alone and (ii) with and without high-risk prognostic factors.</p><p><strong>Results: </strong>In patients with Vp4 PVTT, median OS was 7.6 months (95% CI: 6.0-13.9) with atezolizumab plus bevacizumab (<i>n</i> = 48) and 5.5 months (95% CI: 3.4-6.7) with sorafenib (<i>n</i> = 25; HR 0.62 [95% CI: 0.34-1.11]; descriptive <i>p</i> = 0.104). Median PFS in the respective arms was 5.4 months (95% CI: 3.6-6.9) and 2.8 months (95% CI: 1.5-5.3; HR 0.62 [95% CI: 0.35-1.09]; descriptive <i>p</i> = 0.094). In patients without Vp4, median OS was 21.1 months (95% CI: 18.0-24.6) with atezolizumab plus bevacizumab (<i>n</i> = 288) and 15.4 months (95% CI: 12.6-18.6) with sorafenib (<i>n</i> = 140; HR 0.67 [95% CI: 0.51-0.88]; descriptive <i>p</i> = 0.003). Median PFS in the respective arms was 7.1 months (95% CI: 6.1-9.6) and 4.7 months (95% CI: 4.2-6.1; HR 0.64 [95% CI: 0.51-0.81]; descriptive <i>p</i> < 0.001). The high-risk versus non-high-risk populations had similar outcome patterns. In the respective treatment arms, grade ≥3 treatment-related adverse events occurred in 43% and 48% of patients with Vp4 and 46% and 47% of patients without Vp4.</p><p><strong>Conclusion: </strong>Regardless of VP4 PVTT or other high-risk features of unresectable HCC, which have often resulted in exclusion from other front-line trials, patients benefited from atezolizumab and bevacizumab versus sorafenib.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"13 6","pages":"655-668"},"PeriodicalIF":11.6,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}