Oncology Research and Treatment最新文献

{"title":"The Critical Role of Sex and Gender in Medicine.","authors":"Kathrin Heinrich, Marie von Lilienfeld-Toal","doi":"10.1159/000542508","DOIUrl":"https://doi.org/10.1159/000542508","url":null,"abstract":"","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854762","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":"Navigating Gynecological Oncology with Different Versions of ChatGPT: A Transformative Breakthrough or the Next Black Box Challenge?","authors":"Nur Dokuzeylül Güngör, Fatih Sinan Esen, Tolga Taşçı, Kağan Güngör, Kaan Cil","doi":"10.1159/000543173","DOIUrl":"https://doi.org/10.1159/000543173","url":null,"abstract":"<p><strong>Introduction: </strong>The study evaluates the performance of large language model (LLM) versions of ChatGPT-ChatGPT-3.5, ChatGPT-4, and ChatGPT-Omni-in addressing inquiries related to the diagnosis and treatment of gynecological cancers, including ovarian, endometrial, and cervical cancers.</p><p><strong>Methods: </strong>A total of 804 questions were equally distributed across four categories: True/False, Multiple-Choice, Open-Ended, and Case-scenario, with each question type representing varying levels of complexity. Performance was assessed using a six-point Likert scale, focusing on accuracy, completeness, and alignment with established clinical guidelines.</p><p><strong>Results: </strong>For True/False queries, ChatGPT-Omni achieved accuracy rates of 100% for easy, 98% for medium, and 97% for complicated questions, higher than ChatGPT-4 (94%, 90%, 85%) and ChatGPT-3.5 (90%, 85%, 80%) (p=0.041, 0.023, 0.014, respectively). In Multiple-Choice, ChatGPT-Omni maintained superior accuracy with 100% for easy, 98% for medium, and 93% for complicated queries, compared to ChatGPT-4 (92%, 88%, 80%) and ChatGPT-3.5 (85%, 80%, 70%) (p=0.035, 0.028, 0.011). For Open-Ended questions, ChatGPT-Omni had mean Likert scores of 5.8 for easy, 5.5 for medium, and 5.2 for complex levels, outperforming ChatGPT-4 (5.4, 5.0, 4.5) and ChatGPT-3.5 (5.0, 4.5, 4.0) (p=0.037, 0.026, 0.015). Similar trends were observed in Case-Scenario questions, where ChatGPT-Omni achieved scores of 5.6, 5.3, and 4.9 for easy, medium, and hard levels, respectively (p=0.017, 0.008, 0.012).</p><p><strong>Conclusions: </strong>ChatGPT-Omni exhibited superior performance in responding to clinical queries related to gynecological cancers, underscoring its potential utility as a decision-support tool and an educational resource in clinical practice.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-16"},"PeriodicalIF":2.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847187","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":"Factors associating with bone-only metastasis in Chinese breast cancer patients in the absence of anti-HER2 targeted therapy.","authors":"Zhensheng Li, Liang Chen, Huina Han, Yuguang Shang, Yue Li, Zhifeng Jia, Yunjiang Liu","doi":"10.1159/000543137","DOIUrl":"https://doi.org/10.1159/000543137","url":null,"abstract":"<p><strong>Introduction: </strong>Bone-only metastasis (BOM) is a distinct clinical phenomenon in which cancer cells disseminate exclusively to the bone, without involvement of other distant organs. We investigated the factors associated with the BOM state vs. other states of metastasis in breast cancer patients with bone metastasis (BM) at their first relapse. The results could help tailor the screening and preventive therapy strategies for BM in breast cancer.</p><p><strong>Methods: </strong>The study included 231 women who underwent mastectomy for primary unilateral non-metastatic breast cancer in 1997 or later and were subsequently diagnosed with BM at first relapse in 2008 - 2018 at the Fourth Hospital of Hebei Medical University in China. Factors such as patient age at primary breast cancer diagnosis, tumor clinicopathological characteristics, chemotherapy, radiotherapy, endocrine therapy (ET), time to progression (TTP), and others were analyzed. ET compliance was categorized from medication adherence. Multivariate logistic regression was used to estimate the odd ratio (OR) and p value.</p><p><strong>Results: </strong>Only three (3.8%, 3/79) HER2-positive (HER2+) breast cancer patients (n = 79) used anti-HER2 targeted agents in the adjuvant setting. After excluding them, the remaining 228 patients were analyzed. They had an average age 47.3 years and median TTP 29.4 months at their first relapse. Overall, patients with BOM accounted for 26.8%. The BOM state was similarly in the hormone receptor-positive (HR+) patients (n = 182) and in the HR-negative (HR-) patients (n = 45) (28.6% vs 17.8%, p = 0.142). However, it was significantly lower in the HER2+ patients (n=76) than in the HER2-negative (HER2-) patients (n = 129) (13.2% vs. 31.8%, p = 0.003). Multivariate analyses showed that BOM was not associated with the HR+ (vs. HR-, OR 1.253, p = 0.723) and full ET compliance (vs. no/partial, OR 1.346, p = 0.545) status. Nonetheless, the BOM state was significantly associated with a lower chancer in the HER2+ patients d with a lower chance of BOM overall (OR 0.240, p = 0.008) and in the HR+ patients (OR 0.145, p = 0.005) but not in the HR- patients (OR 1.012, p = 0.991) than one in the HER2- patients. A lower chance of BOM state was also associated with TTP ≥ 24 months (p < 0.05). There were no other associated factors identified.</p><p><strong>Conclusion: </strong>Differently from HR status and other clinicopathological factors, the HER2+ status is associated with a lower chance of the BOM state in breast cancer patients with first BM. Such association appears to be reflected in HR+ patients only.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-21"},"PeriodicalIF":2.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Diagnostic Utility of cfDNA and ctDNA in Liquid Biopsies for Gastrointestinal Cancers Over the Last Decade.","authors":"Nur Rahadiani, Marini Stephanie, Amelia Fossetta Manatar, Ening Krisnuhoni","doi":"10.1159/000543030","DOIUrl":"https://doi.org/10.1159/000543030","url":null,"abstract":"<p><strong>Background: </strong>Cell-free DNA (cfDNA) is a fragmented DNA that is released into the blood through necrosis, apoptosis, phagocytosis, or active secretion. cfDNA includes a subclass called circulating tumor DNA (ctDNA) released from cancer cells and constitutes a varied proportion of the total cfDNA. Both cfDNA and ctDNA hold significant potential as diagnostic biomarkers in gastrointestinal cancers.</p><p><strong>Summary: </strong>cfDNA and ctDNA are promising diagnostic biomarkers for gastrointestinal cancers with varied diagnostic values in different types of cancers. cfDNA offers higher sensitivity that makes it more suitable for screening methods and constant monitoring, particularly in integration with conventional biomarkers or in a multimarker model. On the contrary, ctDNA gives a real-time picture of tumor genetics and is more suitable for definitive diagnosis due to its specificity for tumor-associated alterations. Different types of samples and methods of detection can influence sensitivity, and the amount of cfDNA is higher in serum but plasma is used for cfDNA analysis because it contains less cellular contamination. In summary, cfDNA is more sensitive than ctDNA, although they have comparable or slightly lower specificity.</p><p><strong>Key message: </strong>Further studies are needed to create common guidelines, minimize the cost of analysis, and perform extensive clinical trials to demonstrate the utility of circulating cfDNA and ctDNA in the vast majority of Gastrointestinal cancer stages. Therefore, with the advancement in these technologies, cfDNA and ctDNA will be highly beneficial and evolve cancer diagnostics and therapy.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-23"},"PeriodicalIF":2.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838744","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":"Gender as a contextual factor in quality of life of cancer survivors: A literature review.","authors":"Irene Göttgens, Sabine Oertelt-Prigionea","doi":"10.1159/000543067","DOIUrl":"https://doi.org/10.1159/000543067","url":null,"abstract":"<p><p>Background Cancer survivorship brings numerous challenges extending beyond physical health to include psychological, social, and functional aspects that define the quality of life (QoL) of survivors. Although recognizing that diverse gender experiences lead to different ways of coping with these challenges, many clinical trials fail to account for the distinct constructs of 'sex' and 'gender,' often conflating the two. This review highlights how gender-related aspects can manifest in core QoL domains for cancer survivors, emphasizing the importance of inclusive and effective support systems and interventions. Summary While interest in the impact of gender is increasing in cancer survivor research, the terms 'sex' and 'gender' as still often conflated in research. Gender is a social concept consisting of multiple dimensions, such as gender identity, gender roles and norms and gender relations. Each of these dimensions can have a distinct impact on the quality of life domain of cancer survivors. Research indicates that not gender identity, but gender roles, norms and relations can significantly influence coping behaviors that, subsequently, impact quality of life domains such as physical, emotional, social and role functioning. Understanding the interplay of gender roles, norms and their relations with other contextual social factors is crucial for developing inclusive and effective support systems and interventions for cancer survivors.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-17"},"PeriodicalIF":2.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829487","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":"Real-world survival outcomes in patients with different types of cancer managed with immune checkpoint inhibitors.","authors":"Carsten Nieder, Siv Gyda Aanes, Luka Stanisavljevic, Bård Mannsåker, Ellinor Christin Haukland","doi":"10.1159/000542958","DOIUrl":"https://doi.org/10.1159/000542958","url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitors (ICI) are now standard of care in systemic treatment for many types of metastatic cancer, often together with cytotoxic chemotherapy. Monitoring of treatment efficacy against clinical trial benchmarks in real-world populations and subgroups such as elderly patients is necessary. Based on the results of a previous study, we evaluated age-related survival differences in a larger cohort.</p><p><strong>Methods: </strong>Retrospective analysis of 272 patients managed in a rural real-world setting, after exclusion of those who had received neoadjuvant, adjuvant or maintenance ICI treatment. We defined four different survival categories: death within 3 months of the first ICI dose, 3-6 months survival, 6-12 months survival, and >12 months survival. All surviving patients were followed for >12 months. Actuarial overall survival was assessed too. Age was stratified in 10-year increments.</p><p><strong>Results: </strong>Non-small cell lung cancer (NSCLC) and malignant melanoma represented the most common tumor types. Median age was 70 years. Median actuarial overall survival was 13.6 months (5-year estimate 16%). The best survival was recorded in patients 61-70 years of age. The highest rate of early death within 3 months (29%) was seen in those aged >80 years. Long-term survival was not observed in this age-group, in contrast to all others.</p><p><strong>Conclusion: </strong>Satisfactory survival was observed in this elderly patient cohort, but survival varied with tumor type and performance status. Age was not a major determinant of survival. However, the oldest patients were at higher risk of short survival.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-16"},"PeriodicalIF":2.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780066","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":"Thoracic Oncology Highlights from the European Society for Medical Oncology Annual Meeting 2024: Targeted Therapies in Non-Small Cell Lung Cancer (NSCLC).","authors":"Maximilian Webendoerfer, Sophie Heinzen, Christine Sibbert, Marie-Elisabeth Leßmann, Cornelia Kropf-Sanchen, Michael Thomas, Amanda Tufman, Annalen Bleckmann, Marcel Wiesweg, Frank Griesinger, Lea Reitnauer, Tobias Raphael Overbeck","doi":"10.1159/000542957","DOIUrl":"https://doi.org/10.1159/000542957","url":null,"abstract":"","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770947","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":"Prognostic Significance of HER2 Positivity in Endometrium Cancer.","authors":"Serhat Sekmek, Dogan Bayram, Irfan Karahan, Ismet Seven, Perihan Perkin, Kamil Hakan Muftuoglu, Oznur Bal, Bulent Yalcin, Dogan Uncu, Efnan Algin","doi":"10.1159/000542900","DOIUrl":"10.1159/000542900","url":null,"abstract":"<p><strong>Introduction: </strong>Endometrium cancer is the most common gynecological malignancy in developed countries. In this study, we aimed to investigate the effect of HER2 positivity on prognosis in endometrial cancer.</p><p><strong>Methods: </strong>In our study, patients admitted to our clinic with a diagnosis of endometrial cancer between September 2019 and December 2023 were retrospectively evaluated. Human epidermal growth factor receptor 2 (HER2) immunohistochemistry was performed in 121 patients. HER2-low group (HER2 score: 0 and 1) and HER2-high group (HER2 score: 2 and 3) were defined according to the HER2 immunohistochemistry score in the pathology, and patients were compared accordingly.</p><p><strong>Results: </strong>We observed that 97 (80.2%) of the patients were in the HER2-low group, while 24 (19.8%) were in the HER2-high group. In the OS analysis, age (p = 0.381), menopausal status (p = 0.511), ECOG performance status (p = 0.087), histological type of tumor (p = 0.727), pathological grade (p = 0.206), serum LDH (p = 0.091), and albumin (p = 0.315) levels did not affect the prognosis. Patients with lower FIGO stage (p = 0.003) and HER2-high patients (p = 0.040) had better survival outcomes. Multivariable analysis showed that FIGO stage (p = 0.004) and HER2 status (p = 0.040) were independent risk factors affecting survival in endometrial cancer.</p><p><strong>Conclusion: </strong>As a result of our study, it was observed that FIGO stage and HER2 status were independent risk factors affecting OS in endometrial cancer patients. HER2-high group had a better prognosis than HER2-low group.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-6"},"PeriodicalIF":2.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770943","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":"HER2(-low)-Expression on Circulating Tumor Cells (CTCs) and corresponding Metastatic Tissue in Metastatic Breast Cancer (MBC).","authors":"Lara M Tretschock, Hannah Clemente, Katharina Smetanay, Carlo Fremd, Verena Thewes, Kathrin Haßdenteufel, Anna S Scholz, Klaus Pantel, Sabine Riethdorf, Andreas Trumpp, Andreas Schneeweiss, Laura Michel, Thomas M Deutsch","doi":"10.1159/000542830","DOIUrl":"https://doi.org/10.1159/000542830","url":null,"abstract":"<p><strong>Introduction: </strong>Significant progress has been made in the targeted therapy of metastatic breast cancer (mBC) in recent years. In this context, new biomarkers enable personalized therapy management and individualized therapy monitoring. Therefore, the systemic treatment is based increasingly on the biological characteristics of the tumor disease. Given the challenges of obtaining fresh tumor tissue through biopsies, the significance of liquid biopsies for assessing circulating tumor cells (CTCs) or circulating tumor DNA (ctDNA) is of growing importance for the detection of prognostic and predictive biomarkers. Multiple studies have shown that the number of CTCs decreases under therapy, especially under anti-HER2-targeted therapy, and that the expression of the HER2 status on CTCs could play a role in predicting therapy response and therapeutic monitoring. The aim of this study was to analyze the HER2 status of CTCs in mBC patients before and after 3 months of systemic therapy to evaluate changes in the number of HER2 positive CTCs. The study focuses on HER2-low, which plays an increasingly important role in clinical practice due to new developments of HER2 targeting antibody drug conjugates (ADCs). In this context, temporal and spatial heterogeneity of the disease represent a major diagnostic challenge.</p><p><strong>Methods: </strong>A total of 324 patients with complete immunohistochemistry (IHC) of biopsied metastases were divided into five groups: HER2 negative (-)/hormone receptor (HR) negative (-), HER2 -/HR positive (+), HER2 +/HR +/-, HER2-low/ HR + and HER2-low/ HR -. Before and after 3 months of a new therapeutic line for mBC, CTCs were enumerated and analyzed for HER2 expression using the Cell-Search® system. Overall survival of all subgroups was calculated.</p><p><strong>Results: </strong>The analyses revealed a discrepancy between the HER2 status of CTCs and corresponding tumor tissues in 98 patients (30.2%). The number of CTCs in general and the number of HER2 + CTCs decreased during systemic treatment, mainly in HER2 + tumors, but also in the other subgroups.</p><p><strong>Conclusions: </strong>Discrepancy in the HER2 status of the metastases and of CTCs was observed in approximately one third of patients. Measuring HER2 on CTCs could potentially offer a means to longitudinally monitor HER2 status during therapy and simultaneously address challenges such as tumor heterogeneity. Therefore, the predictive value of HER2 on CTCs should be further investigated in clinical trials.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-30"},"PeriodicalIF":2.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751328","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":"Epidemiology, Real-World Treatment Patterns, and Patient Outcomes of Primary Advanced or Recurrent Endometrial Cancer in Germany between 2015-2021.","authors":"Antje Mevius, Johanna Lutter, Florian M Karl, Liam Tuffy, Fabienne Schochter, Andreas Fuchs, Thomas Wilke","doi":"10.1159/000542773","DOIUrl":"https://doi.org/10.1159/000542773","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to describe the epidemiology of primary advanced or recurrent endometrial cancer and the outcomes from real-world treatment patterns of patients affected in Germany between 2015 to 2021.</p><p><strong>Methods: </strong>In this retrospective cohort study covering the period from 1 January 2015 to 31 December 2021, data from patients with primary advanced or recurrent endometrial cancer who initiated systemic treatment for their disease were extracted from an anonymized claims dataset. Epidemiologic outcomes were cumulative incidence of endometrial cancer and point prevalence. Overall survival after the index date was assessed, with all-cause death used as an event. Endometrial cancer-related real-world treatment patterns were described for the post-index period.</p><p><strong>Results: </strong>The incidence of primary advanced or recurrent endometrial cancer in 2021 was 4.77 cases/100 000 persons, with no substantial change over time (4.63 in 2018; 4.93 in 2019; 4.45 in 2020). The point prevalence on 1 January 2022 was 0.023%, with a slight increase in prevalence observed from 1 January 2019 onwards. Among 466 patients with confirmed endometrial cancer, the mean (standard deviation) age was 68.0 (11.6) years; the tumor material from 86 patients (18.5%) underwent immunohistochemistry or polymerase chain reaction testing. Median overall survival was estimated to be 47.5 months (95% CI 35.1 to 70.4) and the 5-year survival probability was 46.2%. The most frequent first-line systemic therapies were carboplatin (45.7%) and paclitaxel (43.1%). Second-line therapy was received by 153 patients (32.8%).</p><p><strong>Conclusion: </strong>The analysis of the German claims data produced contemporary epidemiologic estimates for advanced or recurrent endometrial cancer. Treatments were aligned with guideline recommendations during the study period, with tumor testing yet to enter mainstream practice.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-20"},"PeriodicalIF":2.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740185","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}