Oral oncology最新文献

{"title":"Feasibility of 3D ultrasound for intraoperative tumor margin assessment in transoral robotic surgery for oropharyngeal squamous cell carcinoma: A pilot study","authors":"Martin Garset-Zamani ,&nbsp;Fatemeh Makouei ,&nbsp;Tina K. Agander ,&nbsp;Giedrius Lelkaitis ,&nbsp;Birgitte W. Charabi ,&nbsp;Jesper F. Tvedskov ,&nbsp;Niclas Rubek ,&nbsp;Anne F. Lomholt ,&nbsp;Theresa D. Frehr ,&nbsp;Rikke Norling ,&nbsp;Christian von Buchwald ,&nbsp;Tobias Todsen","doi":"10.1016/j.oraloncology.2025.107330","DOIUrl":"10.1016/j.oraloncology.2025.107330","url":null,"abstract":"<div><h3>Introduction</h3><div>Close margins after transoral robotic surgery (TORS) in oropharyngeal squamous cell carcinoma (OPSCC) are common due to narrow anatomical boundaries, requiring additional radiotherapy treatment (RT). Ultrasound (US) can be used intraoperatively to distinguish tumors from healthy tissue. Our objective was to explore ex vivo US of surgical specimens from OPSCCs using a novel 3D US method to correlate tumor and margin measurements with histopathology.</div></div><div><h3>Methods</h3><div>Patients with OPSCC undergoing TORS either primarily or as salvage surgery were included. Ex vivo US was performed immediately after resection in the operation room and 3D US models were obtained. The US images were then analyzed by four surgeons blinded to histopathology for correlation analyses. The accuracy to classify close or free margins using a 2 mm threshold was computed.</div></div><div><h3>Results</h3><div>Nine patients with OPSCC were included (median age 63 years, six males, five with previous RT, and five were Human Papillomavirus-positive). US and histopathology had a high correlation for tumor (<em>r</em> = 0.84–0.85) and margin measurements (<em>r</em> = 0.76–0.78). US measured deep margins with a mean difference of 0.5 mm (SD: 1.2 mm) compared to histopathology and had 80% sensitivity to detect areas of the surgical specimens with close margins (&lt;2 mm). US correctly categorized the deep margin status in 89% of the surgical specimens, compared to 44% for the lateral margins.</div></div><div><h3>Conclusions</h3><div>This proof-of-concept study shows that ex vivo 3D US is feasible for intraoperative evaluation of deep surgical margins during TORS of OPSCCs.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"165 ","pages":"Article 107330"},"PeriodicalIF":4.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HPV-mediated PARP1 regulation and drug sensitization in head and neck cancer","authors":"Simona Citro ,&nbsp;Lavinia Ghiani ,&nbsp;Mirko Doni ,&nbsp;Claudia Miccolo ,&nbsp;Marta Tagliabue ,&nbsp;Mohssen Ansarin ,&nbsp;Susanna Chiocca","doi":"10.1016/j.oraloncology.2025.107307","DOIUrl":"10.1016/j.oraloncology.2025.107307","url":null,"abstract":"<div><h3>Introduction</h3><div>Human Papillomavirus (HPV)-positive Head and Neck (HNC) cancer responds better to radiotherapy and platinum-based chemotherapy than HPV-negative HNC, likely due to impaired DNA damage repair. Inhibiting PARP1 enhances the effects of radiation and chemotherapy in tumours with defective DNA repair, such as HPV-positive cancers. In this study we investigated the role of HPV in the upregulation of PARP1, determining HNC cell sensitivity to both olaparib and cisplatin.</div></div><div><h3>Materials and methods</h3><div>PARP1 expression was assessed in HPV-positive and HPV-negative HNC using TCGA data, HNC cell lines and frozen tumour tissue samples from HNC patients. HPV16 expression was modulated by E6/E7 transduction in Human Primary keratinocytes (HK). Sensitivity to the PARP inhibitor olaparib and cisplatin, alone and in combination, was assessed in HNC cell lines.</div></div><div><h3>Results</h3><div>HPV-positive tumours and cell lines showed upregulated PARP1 expression and activity, mediated by HPV16 oncoproteins. HPV-positive cell lines were more sensitive to olaparib or cisplatin treatment than HPV-negative ones. Combining cisplatin with olaparib synergistically inhibited cell viability in all HNC cell lines tested, regardless of HPV status.</div></div><div><h3>Conclusion</h3><div>Our study demonstrates that PARP1 is upregulated in HPV-positive HN tumours and cell lines, compared to HPV-negative. Despite the higher sensitivity of HPV-positive HNC cell lines to olaparib and cisplatin compared to HPV-negative cells, the combination of cisplatin with olaparib synergistically inhibits cell viability across all HNC cell lines tested, regardless of HPV status. This combination may allow for reduced drug concentrations, potentially decreasing side effects and enhancing therapeutic efficacy in HN tumours.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"165 ","pages":"Article 107307"},"PeriodicalIF":4.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extramedullary plasmacytoma of the Gingiva: A rare case report and clinical management","authors":"Xin Wei ,&nbsp;Jiayu Shen ,&nbsp;Shize Zheng,&nbsp;Hanyan Dai,&nbsp;Xi Li,&nbsp;Zhiyan Wu,&nbsp;Yifu Bian,&nbsp;Zhimin Xu,&nbsp;Peng Liu","doi":"10.1016/j.oraloncology.2025.107315","DOIUrl":"10.1016/j.oraloncology.2025.107315","url":null,"abstract":"<div><div>Extramedullary plasmacytoma (EMP) of the gingiva is an exceptionally rare plasma cell neoplasm, posing significant diagnostic challenges due to its nonspecific clinical presentation and low incidence. This case report details a 67-year-old male presenting with a painless right maxillary gingival mass, initially mimicking benign hyperplasia. Diagnostic workup, including cone-beam computed tomography (CBCT), revealed osteolytic bone destruction and soft tissue expansion. Histopathological and immunohistochemical (IHC) analyses confirmed monoclonal plasma cell proliferation (CD38+, CD79a+, MUM-1+, κ-light chain restriction) with a markedly elevated Ki-67 index (80 %). Radical surgical resection achieved R0 margins, and adjuvant radiotherapy was deferred based on complete excision. The case highlights critical diagnostic considerations: EMP necessitates differentiation from chronic gingivitis, B-cell lymphomas, and head/neck malignancies, with immunohistochemistry (CD138, κ/λ restriction) and PET-CT serving as pivotal tools. The observed Ki-67 elevation aligns with evidence suggesting higher proliferative activity in EMP compared to solitary bone plasmacytomas, emphasizing the role of risk-adapted adjuvant therapy for tumors with Ki-67 &gt; 50 %. Furthermore, κ-light chain predominance (&gt;90 %) underscores clonal proliferation dynamics, while longitudinal surveillance for systemic progression to multiple myeloma remains imperative. This report advocates for early biopsy of atypical oral lesions, multidisciplinary collaboration, and lifelong monitoring to mitigate diagnostic delays and optimize outcomes. It underscores the importance of integrating molecular profiling (e.g., 1q21/MYC status) into prognostic models for this rare entity, ultimately guiding precision management strategies.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"165 ","pages":"Article 107315"},"PeriodicalIF":4.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Histological tumor necrosis predicts decreased survival after neoadjuvant chemotherapy in head and neck squamous cell carcinoma”","authors":"John Lennon Silva Cunha","doi":"10.1016/j.oraloncology.2025.107336","DOIUrl":"10.1016/j.oraloncology.2025.107336","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"165 ","pages":"Article 107336"},"PeriodicalIF":4.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence and prognostic value of CD168 in early-stage oral squamous cell carcinoma","authors":"Maximilian Richter ,&nbsp;Christian Doll ,&nbsp;Elena Hofmann ,&nbsp;Anna Reds ,&nbsp;Friedrich Mrosk ,&nbsp;Konrad Neumann ,&nbsp;Max Heiland ,&nbsp;Steffen Koerdt ,&nbsp;Jan-Dirk Raguse ,&nbsp;Korinna Jöhrens","doi":"10.1016/j.oraloncology.2025.107329","DOIUrl":"10.1016/j.oraloncology.2025.107329","url":null,"abstract":"<div><h3>Objective</h3><div>CD168 has been established as a negative prognostic marker in various tumor entities leading to a poor prognosis. Regarding OSCC, there is a lack of comprehensive studies that examine the correlation between CD168 expression and clinical outcome, hindering the implementation of this prognostic factor into clinical practice.</div></div><div><h3>Materials and Methods</h3><div>This retrospective analysis included all patients with primary pT1 and pT2 pN0 OSCC who received surgical therapy without the need for adjuvant therapy (pN0, M0, R0) over a seven-year long period. Immunohistochemical staining for CD168 and Mib/Ki67 was evaluated using tissue microarrays of primary tumors and correlated with clinical outcome. A cut-off value for CD168 expression of ≥10 % was considered as positive.</div></div><div><h3>Results</h3><div>A total of 139 patients (male: 91 (65.5 %), female: 48 (34.5 %)) with a mean age of 61.2 years were included (mean follow-up: 62.6 months). CD168 expression was evident in 35 (25.2 %) tumors leading to higher levels of Mib/Ki67 positivity (p &lt; 0.001). Tumor biopsies of stage T2 OSCC stained positive for CD168 more frequently when compared to T1 tumors (p = 0.002). Tumors with CD168 expression ≥ 10 % had a significantly lower OS (p &lt; 0.001) and RFS (p = 0.011) compared to patients with lower expression. Multivariate Cox regression identified CD168 status as a risk factor for OS (HR 2.10, CI: 1.06–4.14; p = 0.033).</div></div><div><h3>Conclusion</h3><div>Our results demonstrate a significant proportion of CD168-positive tumors in OSCC and suggest an impact on prognosis, particularly with regard to OS.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"165 ","pages":"Article 107329"},"PeriodicalIF":4.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The predictive value of tumor depth of invasion for contralateral neck disease in tongue cancer","authors":"Logesvar Balaguru ,&nbsp;Cristina Benites ,&nbsp;Krishna S. Hanubal ,&nbsp;Gonghao Liu ,&nbsp;Ji-Hyun Lee ,&nbsp;Dustin Conrad ,&nbsp;Colyn White ,&nbsp;Arunima Vijay ,&nbsp;Peter T. Dziegielewski","doi":"10.1016/j.oraloncology.2025.107334","DOIUrl":"10.1016/j.oraloncology.2025.107334","url":null,"abstract":"<div><h3>Objective</h3><div>Management of the contralateral cN0 neck in well-lateralized oral tongue squamous cell carcinoma (OTSCC) is controversial. Depth of invasion (DOI) is a strong predictor of ipsilateral nodal metastases. This study examines if DOI can predict contralateral neck disease (CND).</div></div><div><h3>Material and Methods</h3><div>A retrospective analysis was performed on patients treated with primary surgery for lateralized OTSCC at a single tertiary care academic institution from 2014 to 2021. Multivariable analysis was performed to assess the relationship between DOI and CND.</div></div><div><h3>Results</h3><div>155 patients were included. 101 (65.2%) patients had T1/T2 disease, while 54 (34.8%) had T3/T4 disease. 22 (14.2%) patients had CND. Mean DOI of patients with CND and without CND was 21.0 mm and 9.8 mm (<em>p</em> &lt; 0.001), respectively. Univariable regression models showed higher DOI was associated with increased risk of CND overall (OR = 1.11, 95% CI: 1.06, 1.17, <em>p</em> &lt; 0.001), in patients with T1 disease (OR = 1.38, 95% CI: 1.11, 2.20, <em>p</em> = 0.038), and in patients with cN0 disease (OR = 1.09, 95% CI: 1.01, 1.17, <em>p</em> = 0.028). Multivariable regression model confirmed higher DOI was associated with increased risk of CND (OR = 1.09, 95% CI: 1.04, 1.16, <em>p</em> = 0.001). A DOI of 6 mm was identified as a potential threshold for increased risk of CND.</div></div><div><h3>Conclusion</h3><div>DOI was identified as a predictive factor for CND in OTSCC. At the time of ipsilateral neck dissection, a DOI ≥ 6 mm may represent a threshold associated with an increased risk of CND, indicating that contralateral neck management could be considered.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"165 ","pages":"Article 107334"},"PeriodicalIF":4.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implication of circulating miRNAs as potential diagnostic biomarker in oropharyngeal squamous cell Carcinoma: Association with Human Papilloma Virus","authors":"Swati Kumari ,&nbsp;Sridhar Mishra ,&nbsp;Wahid Ali ,&nbsp;Uma Shankar Singh ,&nbsp;Nida Shabbir ,&nbsp;Vijay Kumar ,&nbsp;Naseem Akhtar ,&nbsp;Rahat Hadi","doi":"10.1016/j.oraloncology.2025.107305","DOIUrl":"10.1016/j.oraloncology.2025.107305","url":null,"abstract":"<div><h3>Background</h3><div>Over the past decades, significant progress has been made in the early diagnosis and treatment of oropharyngeal squamous cell carcinoma (OPSCC). However, the survival rate has not improved. Human papillomavirus (HPV) is a major risk factor for the development of oropharyngeal cancer. Therefore, understanding the molecular mechanisms underlying OPSCC may help define improved diagnostic and prognostic strategies. Previous studies on tissue samples have linked microRNAs (miRNAs) to the progression of OPSCC. This study aimed to develop a panel of diagnostic biomarkers based on the serum miRNA signature in OPSCC that correlates with HPV status.</div></div><div><h3>Materials and Methods</h3><div>Paired serum and tissue samples were collected from 30 OPSCC patients and 20 healthy controls. Based on previous studies on OPSCC tissue samples, a set of six miRNAs (miR-93, miR-222, miR-199, miR-320, miR-145, and miR-126) was selected due to their association with OPSCC development and progression. RT-qPCR was used to compare miRNA expression in paired samples, with miR-16 serving as the reference gene for normalization. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic potential of these serum miRNAs.</div></div><div><h3>Results</h3><div>The mean relative fold change for serum miR-93 and miR-222 was upregulated, whereas miR-199, miR-320, miR-145, and miR-126 were downregulated in OPSCC compared to normal controls. A similar trend of upregulation and downregulation was observed in tissue samples. The mean relative expression of miR-93 was significantly associated with HPV status (p &lt; 0.0001). Additionally, the mean relative expression levels of all six miRNAs (miR-93, miR-222, miR-199, miR-320, miR-145, and miR-126) were significantly different between the serum of normal controls and early-stage OPSCC patients. The serum miRNA panel, including miR-93, miR-222, miR-199, miR-320, miR-145, and miR-126, demonstrated significant diagnostic potential in distinguishing OPSCC from normal controls.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that a panel of OPSCC-related miRNAs demonstrates concordant expression levels in serum and tissue of OPSCC, and may serve as a minimally invasive diagnostic biomarker for OPSCC. Further studies with a larger sample size are needed to confirm these findings, particularly in HPV-associated OPSCC.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"165 ","pages":"Article 107305"},"PeriodicalIF":4.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The epidemiological trends and survival of HPV-related oropharyngeal cancer other than tonsils and base of tongue − a systematic review and meta-analysis","authors":"Anas Mohammad Al Fadel,&nbsp;Kathrine Kronberg Jakobsen,&nbsp;Lasse Holmgaard Jensen,&nbsp;Amanda-Louise Fenger Carlander,&nbsp;Christian Grønhøj,&nbsp;Christian von Buchwald","doi":"10.1016/j.oraloncology.2025.107311","DOIUrl":"10.1016/j.oraloncology.2025.107311","url":null,"abstract":"<div><h3>Importance</h3><div>Human papillomavirus (HPV) is a well-established cause of oropharyngeal squamous cell carcinoma (OPSCC) located in the tonsils and base of tongue, but the association with other oropharyngeal subsites (otherOPSCC) remains unclear. This study aimed to examine the worldwide prevalence of HPV in otherOPSCC and its impact on survival utilizing the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.</div></div><div><h3>Methods</h3><div>The study outcomes and measures were planned at PROSPERO in advance. PubMed was searched from the earliest available record to September 1st, 2023. We included studies reporting otherOPSCC and known HPV-status. Exclusion criteria were (1) studies with ten or less otherOPSCC cases (2) studies with unspecified OPSCC subsite or with unknown primary tumor location (3) review articles, <em>meta</em>-analyses, and case reports (4) studies that focused exclusively on HPV+ or HPV- OPSCC. Two authors independently extracted the data.<!--> <!-->Risk of bias assessment was done using the ROBINS-E tool. The meta-analysis was conducted utilizing a random-effects model.</div></div><div><h3>Results</h3><div>A total of 42 studies met the inclusion criteria comprising 20 unique cohorts with a total of 6442 patients (range 11–3776). A meta-analysis showed an overall HPV prevalence of 20% (95% CI 13% 30%). We found no significant differences in the 5-year OS between HPV + otherOPSCC and HPV- otherOPSCC (56% [95% CI 29% 80%] vs 45% [95% CI 41% 49%], p = 0.43).</div></div><div><h3>Conclusion</h3><div>Our study revealed a low HPV prevalence in otherOPSCC (20%). HPV is not a useful prognostic factor in other OPSCCs than palatine tonsils and base of tongue locations.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"165 ","pages":"Article 107311"},"PeriodicalIF":4.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric comparison of oral tongue dose with tongue-out radiation therapy compared to non-tongue-out radiation therapy for head & neck cancer: Clinical implications for mitigating post-radiation therapy dysgeusia","authors":"Whoon Jong Kil ,&nbsp;Wyatt Smith ,&nbsp;David Cousins","doi":"10.1016/j.oraloncology.2025.107335","DOIUrl":"10.1016/j.oraloncology.2025.107335","url":null,"abstract":"<div><div>Authors report oral tongue (OT)-sparing radiotherapy (RT) with tongue-out (TORT) for various virtual primary head and neck cancer (HNC). TORT lowered D_mean to OT by 25 % than non-TORT (22.4 <em>vs</em> 29.4 Gy, p &lt; 0.05); V₃₀ by 65 % (15.2 % <em>vs</em> 43.3 %, p &lt; 0.05) suggesting clinical implications for minimizing post-RT dysgeusia in HNC patients.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"165 ","pages":"Article 107335"},"PeriodicalIF":4.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral complications from treatment for human papilloma virus-positive oropharyngeal cancer","authors":"Alessandro Villa ,&nbsp;Stephen Sonis","doi":"10.1016/j.oraloncology.2025.107306","DOIUrl":"10.1016/j.oraloncology.2025.107306","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"165 ","pages":"Article 107306"},"PeriodicalIF":4.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}