Melanoma ResearchPub Date : 2025-02-01Epub Date: 2024-12-03DOI: 10.1097/CMR.0000000000001012
Ken Horisaki, Shusuke Yoshikawa, Wataru Omata, Arata Tsutsumida, Yoshio Kiyohara
{"title":"Clinical features of vulvar and vaginal malignant melanomas and the effects of immune checkpoint inhibitors in Japanese patients: a single-center, retrospective cohort study.","authors":"Ken Horisaki, Shusuke Yoshikawa, Wataru Omata, Arata Tsutsumida, Yoshio Kiyohara","doi":"10.1097/CMR.0000000000001012","DOIUrl":"10.1097/CMR.0000000000001012","url":null,"abstract":"<p><p>Vulvar and vaginal melanomas (VVMs) are rare malignancies, but they are relatively more common among Asian women. This makes the collection of data on VVMs in this population crucial. Moreover, no cohort studies have examined and compared the effects of immune checkpoint inhibitors (ICIs) on VVM in Asian women. Therefore, we aimed to investigate the clinical characteristics of VVMs in Japanese women and the effects of ICI treatment. This single-center, retrospective cohort study included patients who were histologically diagnosed with VVM at our hospital between March 2005 and December 2023. The Kaplan-Meier analysis was used to compare the prognosis of vulvar melanoma (VuM) and vaginal melanoma (VaM) throughout entire treatments and compare the efficacies of ICIs and conventional chemotherapies in VVM. In total, 28 women with VuM ( n = 14) and VaM ( n = 14) were included. There were no significant differences in overall survival (OS) [median OS: not reached (95% confidence interval (CI), 13.2-NA) vs. 30.2 months (95% CI, 23.2-NA), log-rank test, P = 0.456] between the VuM and VaM groups. The progression-free survival (median progression-free survival: 14.7 vs. 5.2 months, P = 0.002) and OS (median OS: 33.8 vs. 7.2 months, P < 0.001) were significantly better for the ICI-treated group than for the conventional chemotherapy-treated group in VVM. The prognosis of patients with VVM improved significantly with the advent of ICI, demonstrating the importance of ICI in the treatment of VVM.</p>","PeriodicalId":18550,"journal":{"name":"Melanoma Research","volume":" ","pages":"67-74"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780576","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}
Melanoma ResearchPub Date : 2025-02-01Epub Date: 2024-10-08DOI: 10.1097/CMR.0000000000001006
Michele Kreuz, Francisco Cezar Aquino de Moraes, Vitor Kendi Tsuchiya Sano, Fernando Luiz Westphal Filho, Ana Laura Soares Silva, Francinny Alves Kelly
{"title":"Association of baseline neutrophil-to-lymphocyte ratio and prognosis in melanoma patients treated with PD-1/PD-L1 blockade: a systematic review and meta-analysis.","authors":"Michele Kreuz, Francisco Cezar Aquino de Moraes, Vitor Kendi Tsuchiya Sano, Fernando Luiz Westphal Filho, Ana Laura Soares Silva, Francinny Alves Kelly","doi":"10.1097/CMR.0000000000001006","DOIUrl":"10.1097/CMR.0000000000001006","url":null,"abstract":"<p><p>Immunotherapy treatments that target programmed cell death receptor-1 (PD-1) or its ligand (PD-L1) have revolutionized the treatment of metastatic melanoma and currently represent the standard first-line treatment for this type of cancer. However, it is still not entirely clear which biomarkers are cost-effective, simple, and highly reliable. This systematic review and meta-analysis aims to analyze the predictive value of the baseline neutrophil-lymphocyte ratio (NLR) regarding disease progression and overall survival of patients with metastatic melanoma undergoing treatment with PD-1/PD-L1 blockade. PubMed, Scopus, and Web of Science were searched for studies comparing high versus low NLR. We performed the meta-analysis using RStudio v4.4.2 software. A total of 20 studies and 2691 patients were included, all with diagnoses of melanoma. The majority of the individuals were male 2278 (84, 65%). The median overall survival (OS) and progression-free survival (PFS) ranged from 5.0 to 44.4 and from 1.8 to 15.0 months, respectively. Compared with the high NLR ratio, the low exposure group achieved better rates of OS [hazard ratio (HR), 2.07; 95% CI, 1.73-2.48; P < 0.00001; I ² = 47%]. Regarding PFS, there was a statistically significant difference between groups with tendencies toward the low NLR exposure group (HR, 1.59; 95% CI, 1.39-1.81; P < 0.00001; I²=31%]. This systematic review and meta-analysis revealed significant lower OS in melanoma patients treated with PD-1/PD-L1 blockade who had elevated baseline NLR values. Furthermore, an increased PFS was observed in patients with a lower baseline NLR value. This study highlights NLR as an important prognostic biomarker for patients with metastatic melanoma who are candidates for treatment with PD-1 and PD-L1.</p>","PeriodicalId":18550,"journal":{"name":"Melanoma Research","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623784","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}
Melanoma ResearchPub Date : 2025-02-01Epub Date: 2024-11-25DOI: 10.1097/CMR.0000000000001007
Lejie Zheng, Alyssa Kathleen Susanto, H Peter Soyer, Monika Janda, Soraia de Camargo Catapan
{"title":"Psychosocial wellbeing in people with melanoma in-situ: a systematic review.","authors":"Lejie Zheng, Alyssa Kathleen Susanto, H Peter Soyer, Monika Janda, Soraia de Camargo Catapan","doi":"10.1097/CMR.0000000000001007","DOIUrl":"10.1097/CMR.0000000000001007","url":null,"abstract":"<p><p>This systematic review aims to evaluate the prevalence of reductions in psychosocial wellbeing among patient with melanoma in situ (MIS). It also aims to identify factors associated with psychosocial reactions, the instruments used to measure psychosocial outcomes, and to evaluate existing intervention programs for supporting this population. Search strategies for different databases including PubMed, Embase, Scopus, PsycINFO, and Web of Science were designed and implemented. A total of 2378 records were identified, resulting in 22 included papers. Various aspects of psychosocial wellbeing were evaluated in the reviewed articles, with fear of cancer recurrence being the most frequently investigated among patients diagnosed with melanoma. Only 2 of the 22 studies reported data for MIS patients, indicating no significant difference in psychosocial welling between patients with MIS and those at higher stages. Regarding interventional support, there is a notable lack of interventions specifically addressing the psychosocial needs of MIS patients. Our findings highlight a significant research gap on psychosocial wellbeing following a MIS diagnosis and suggest a shortage of targeted psychosocial interventions for this growing patient population. The observed variability in measuring psychosocial aspects presents challenges in identifying the essential components of effective interventions. Future research should prioritize employing mixed methodologies and addressing the unique needs of MIS patients.</p>","PeriodicalId":18550,"journal":{"name":"Melanoma Research","volume":" ","pages":"11-23"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623787","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}
Melanoma ResearchPub Date : 2024-12-01Epub Date: 2024-10-30DOI: 10.1097/CMR.0000000000001004
Joshua Burshtein, Milaan Shah, Danny Zakria, Darrell Rigel
{"title":"The association between dermatologist density and melanoma prognosis using melanoma mortality-incidence ratio.","authors":"Joshua Burshtein, Milaan Shah, Danny Zakria, Darrell Rigel","doi":"10.1097/CMR.0000000000001004","DOIUrl":"https://doi.org/10.1097/CMR.0000000000001004","url":null,"abstract":"","PeriodicalId":18550,"journal":{"name":"Melanoma Research","volume":"34 6","pages":"550-552"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546343","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}
Melanoma ResearchPub Date : 2024-12-01Epub Date: 2024-09-05DOI: 10.1097/CMR.0000000000001002
Akshaya Arjunan, Mary Wardrop, Marcus M Malek, Alexander J Davit, Michael R Sargen, John M Kirkwood, Kathryn Demanelis, Brittani K N Seynnaeve
{"title":"Treatment outcomes following partial shave biopsy of atypical and malignant melanocytic tumors in pediatric patients.","authors":"Akshaya Arjunan, Mary Wardrop, Marcus M Malek, Alexander J Davit, Michael R Sargen, John M Kirkwood, Kathryn Demanelis, Brittani K N Seynnaeve","doi":"10.1097/CMR.0000000000001002","DOIUrl":"10.1097/CMR.0000000000001002","url":null,"abstract":"<p><p>Pediatric melanoma is the most common skin cancer in children and treatment relies on accurate staging. The American Academy of Dermatology recommends excisional biopsy for suspicious skin lesions, however, partial shave biopsies are often performed, the impact of which is unknown in pediatric and adolescent/young adult (AYA) patients. The aim of this retrospective case series study was to evaluate the impact of the diagnostic biopsy method on staging, treatment, and treatment-related outcomes in pediatric/AYA patients with melanoma. Among 103 pediatric/AYA patients with atypical cutaneous melanocytic lesions, the most common biopsy method was partial shave (68/103, 66.0%) followed by punch (20/103, 19.4%), excisional (14/103, 13.6%), and incisional nonshave (1/103, 1%). Over half of all biopsies yielded a positive deep margin, reflecting compromised microstaging (56/103, 55.4%), the majority occurred following partial shave (52/56, 92.9%) compared with other techniques ( P < 0.001). All 11 patients with wider surgical target margins of wide local excision and 8/9 patients with sentinel lymph node biopsy performed due to positive deep margin, underwent a partial shave biopsy ( P = 0.05 and 0.32, respectively). Almost half of all patients who underwent partial shave biopsy had a clinically suspected abnormal melanocytic tumor prior to biopsy (31/68, 45.6%; P = 0.03). Of 56 patients who had compromised microstaging, 17 (30.4%) had a diagnosis of melanoma ( P = 0.17). Pediatric/AYA patients frequently undergo partial shave biopsy, which is associated with more invasive definitive surgical treatment due to compromised microstaging. These results may help optimize care of patients with cutaneous melanocytic tumors.</p>","PeriodicalId":18550,"journal":{"name":"Melanoma Research","volume":" ","pages":"544-548"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133182","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}
Melanoma ResearchPub Date : 2024-12-01Epub Date: 2024-10-30DOI: 10.1097/CMR.0000000000000993
Saichun Zhang, Zixiang Liu, Dongsheng Zhu
{"title":"Development and validation of prognostic nomogram in pediatric melanoma: a population-based study.","authors":"Saichun Zhang, Zixiang Liu, Dongsheng Zhu","doi":"10.1097/CMR.0000000000000993","DOIUrl":"10.1097/CMR.0000000000000993","url":null,"abstract":"<p><p>The aim of the study is to use the Surveillance, Epidemiology, and End Results (SEER) database to develop a useful clinical nomogram that uses prognosis prediction for pediatric melanoma patients. We obtained clinical information on pediatric melanoma patients from the SEER database between 2000 and 2018. Each patient was split into a training cohort or a validation cohort at random. Results between various subgroups were compared using Kaplan-Meier analyses. We created a nomogram to calculate the probability of survival for pediatric patients with melanoma. The performance of nomograms was assessed using calibration and discrimination. To assess the clinical use of this newly created model, decision curve analysis was also performed. In this study, a total of 890 eligible patients were chosen at random and allocated to 70% of training cohorts ( n = 623) and 30% of validation cohorts ( n = 267). After applying the chosen various components to create a nomogram, validated indexes showed that the nomogram had a strong capacity for discrimination. The training set's and validation set's C-index values were 0.817 and 0.832, respectively. The calibration plots demonstrated a strong correlation between the observation and the forecast. The model has a good clinical net benefit for pediatric melanoma patients, according to the clinical decision curve. In conclusion, we created an effective survival prediction model for pediatric melanoma. This nomogram is accurate and useful for clinical decision-making. Still, more external confirmation is required.</p>","PeriodicalId":18550,"journal":{"name":"Melanoma Research","volume":" ","pages":"497-503"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855995","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}
Melanoma ResearchPub Date : 2024-12-01Epub Date: 2024-10-04DOI: 10.1097/CMR.0000000000001003
Giovanni Paolino, Antonio Podo Brunetti, Carolina De Rosa, Carmen Cantisani, Franco Rongioletti, Andrea Carugno, Nicola Zerbinati, Mario Valenti, Domenico Mascagni, Giulio Tosti, Santo Raffaele Mercuri, Riccardo Pampena
{"title":"Anorectal melanoma: systematic review of the current literature of an aggressive type of melanoma.","authors":"Giovanni Paolino, Antonio Podo Brunetti, Carolina De Rosa, Carmen Cantisani, Franco Rongioletti, Andrea Carugno, Nicola Zerbinati, Mario Valenti, Domenico Mascagni, Giulio Tosti, Santo Raffaele Mercuri, Riccardo Pampena","doi":"10.1097/CMR.0000000000001003","DOIUrl":"10.1097/CMR.0000000000001003","url":null,"abstract":"<p><p>Anorectal melanoma (ARM) is a rare malignancy often associated with a poor prognosis due to its late diagnosis and aggressive biological behavior. This review aims to comprehensively investigate ARM's diagnosis, management, and treatment, emphasizing its clinical characteristics, laboratory findings, and implications for patient prognosis. A systematic literature search was conducted in PubMed, Embase, and Cochrane CENTRAL databases from inception to 1 July 2024. This review synthesizes existing literature to provide a comprehensive understanding of this rare primary malignancy. A total of 110 articles reporting on 166 patients were included. Gender data were available for 131 cases, comprising 67 females (51.1%) and 64 males (48.9%). The median age was 66 years. The overall median time to diagnosis was 4 months for anal melanoma, 3 months for rectal melanoma, and 4 months for anorectal junction melanoma. The clinical presentation was nodular in 98.2% of cases. Pre-diagnosis symptoms included bleeding in 84.9% of cases, mucous elimination (6%), pain (68.7%), tenesmus (16.9%), and changes in bowel movements (28.5%). Overall survival (OS) was reported in 82 cases, with a median OS of 11 months: 11 months for anal melanoma, 7 months for rectal melanoma, and 12 months for anorectal junction melanoma. ARM is a rare and aggressive melanoma subtype often diagnosed at an advanced stage, leading to a poor prognosis. A female predominance was observed, consistent with other mucosal melanomas. Anal melanoma exhibited better progression-free survival, and OS compared to rectal and anorectal junction melanoma.</p>","PeriodicalId":18550,"journal":{"name":"Melanoma Research","volume":" ","pages":"487-496"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365808","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}
Melanoma ResearchPub Date : 2024-12-01Epub Date: 2024-10-30DOI: 10.1097/CMR.0000000000000995
Brandon Smith, Joe K Tung, Annie I Chen, Cassandra Mohr, Malgorzata K Nowakowska, Mackenzie R Wehner, Laura K Ferris
{"title":"Total body skin examination visits by dermatology providers in the 2011-2016 National Ambulatory Medical Care Survey.","authors":"Brandon Smith, Joe K Tung, Annie I Chen, Cassandra Mohr, Malgorzata K Nowakowska, Mackenzie R Wehner, Laura K Ferris","doi":"10.1097/CMR.0000000000000995","DOIUrl":"https://doi.org/10.1097/CMR.0000000000000995","url":null,"abstract":"","PeriodicalId":18550,"journal":{"name":"Melanoma Research","volume":"34 6","pages":"549-550"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546344","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}
Melanoma ResearchPub Date : 2024-12-01Epub Date: 2024-06-24DOI: 10.1097/CMR.0000000000000989
Vincenzo De Giorgi, Giovanni Cecchi, Gabriella Perillo, Biancamaria Zuccaro, Piero Covarelli
{"title":"Synchronous double primary vulvar melanoma: a not so rare possibility. A clinical and dermoscopic case study.","authors":"Vincenzo De Giorgi, Giovanni Cecchi, Gabriella Perillo, Biancamaria Zuccaro, Piero Covarelli","doi":"10.1097/CMR.0000000000000989","DOIUrl":"10.1097/CMR.0000000000000989","url":null,"abstract":"<p><p>Vulvar melanoma is considered rare, but it is the second most frequent vulvar neoplasm; 2% of melanomas in women arise in the vulvar area. It is important to highlight how the characteristics of vulvar melanoma differentiate it from classic cutaneous melanoma. Vulvar melanoma has different risk factors and clinical and dermoscopic characteristics; moreover, it has a higher recurrence rate and a greater likelihood of multifocality. Here, we present a case of a 44-year-old patient with two primary vulvar melanomas located on opposite sides of her vulva. The lesions were both flat, but they had distinct clinical and dermoscopic appearances. Melanoma of the genital tract is likely the result of a multifocal disorder of the melanocytes within the mucosa that inhabit the perineal squamous epithelium. The risk factors of vulvar melanoma differ from those of classical cutaneous melanomas. Vulvar melanoma occurs in an area shielded from ultraviolet radiation; the primary risk factors include chronic inflammatory disease, genetic susceptibility, irritant agents and viral infections. This case study reveals how a close examination of the genital area is important and how dermoscopy can aid in the differential diagnosis of vulvar lesions. Inspections of the genital area should be particularly thorough if a melanoma is detected there, given the higher risk of multifocality in that part of the body.</p>","PeriodicalId":18550,"journal":{"name":"Melanoma Research","volume":" ","pages":"540-543"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443066","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}
Melanoma ResearchPub Date : 2024-12-01Epub Date: 2024-08-30DOI: 10.1097/CMR.0000000000001000
Isaac Kim, Jisu Oh, Siyeoung Yoon, Man-Yong Han, Jaiwoo Chung, Younghoon Jung, Hyun-Il Lee, Soonchul Lee
{"title":"Pediatric melanoma incidence and survival: a fifteen-year nationwide retrospective cohort study in Korea.","authors":"Isaac Kim, Jisu Oh, Siyeoung Yoon, Man-Yong Han, Jaiwoo Chung, Younghoon Jung, Hyun-Il Lee, Soonchul Lee","doi":"10.1097/CMR.0000000000001000","DOIUrl":"10.1097/CMR.0000000000001000","url":null,"abstract":"<p><p>The aim of this study was to explore the epidemiology of cutaneous malignant melanoma (CMM) and the associated risk factors influencing its occurrence and survival among Koreans aged <20 years. In this retrospective cohort investigation, we identified cases of incident melanoma diagnosed in Korean patients aged 0-19 years between 2004 and 2019, utilizing the National Health Insurance database. We assessed annual fluctuations in age-adjusted incidence rates and examined 5-year survival rates based on various factors, including sex, age, income level, sun-exposed sites, and the Charlson Comorbidity Index. Of 1160 patients, 51.4% were male and 48.6% were female. The mean age of the patients was 11 years, mostly belonging to the top 25% high-income group. The head and neck regions were the most frequently affected sites. The overall age-adjusted incidence rate of melanoma was 0.22 per 100,000 persons. This rate witnessed a decline of 4.5% annually from 2004 to 2012, followed by a subsequent increase of 12.6% annually from 2012 to 2019. Notably, patients with CMM in low-sun-exposed sites exhibited poorer survival rates compared with those in high-sun-exposed areas ( P < 0.05). The incidence of melanomas in children and adolescents in Korea has shown a rising trend since 2012. Further research is needed to investigate the etiology and risk factors in pediatric patients.</p>","PeriodicalId":18550,"journal":{"name":"Melanoma Research","volume":" ","pages":"528-534"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142109347","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}