Oral oncology最新文献

{"title":"Thyroid volumes after intensity‐modulated radiotherapy as predictors of radiation‐induced hypothyroidism in nasopharyngeal carcinoma: A retrospective study","authors":"Zhe Dong ,&nbsp;Gao-Yuan Wang ,&nbsp;Guan-Jie Qin,&nbsp;Dong-Yu Dai,&nbsp;Wen-Fei Li,&nbsp;Ling-Long Tang,&nbsp;Cheng Xu,&nbsp;Jun Ma","doi":"10.1016/j.oraloncology.2025.107223","DOIUrl":"10.1016/j.oraloncology.2025.107223","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to investigate the ability of thyroid volumes after intensity-modulated radiotherapy (IMRT) to predict the incidence of radiation‐induced hypothyroidism/primary hypothyroidism (HT)/(PHT) in nasopharyngeal carcinoma (NPC) patients.</div></div><div><h3>Methods and materials</h3><div>404 NPC patients were retrospectively enrolled from January 2015 to January 2019. Thyroid volumes were calculated based on magnetic resonance imaging. Volume of thyroid after IMRT within 3 months was defined as Vt-after. Least absolute shrinkage and selection operator (LASSO) regression, random forest analysis, and multivariate Cox proportional hazards were performed to identify optimal predictors of PHT. Then, these predictors were employed to construct the risk stratification using the recursive partitioning analysis (RPA).</div></div><div><h3>Results</h3><div>A smaller Vt-after was significantly associated with a higher risk of HT/PHT (hazard ratio (HR): 2.046, <em>p</em> &lt; 0.001; HR: 3.214, <em>p</em> &lt; 0.001; respectively). Vt-after and thyroid volumes at 1, 2, and 3 years after IMRT demonstrated superior predictive ability compared to the thyroid volume before IMRT for predicting PHT within the subsequent 2-year period. The combination of Vt-after and thyroid volume spared from 45 Gy (VS45), both of which were<!--> <!-->independent factors for predicting PHT, was incorporated into the RPA risk stratification called PRA-VS45. The PRA-VS45 emerged as a highly discriminative tool, with an area under the curve (AUC) of 0.716 on predicting PHT at 5 years.</div></div><div><h3>Conclusions</h3><div>This study identified thyroid volumes after IMRT as valuable parameters to predict radiation‐related PHT in NPC patients. The PRA-VS45 has the potential to be clinical applications for predicting PHT.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"163 ","pages":"Article 107223"},"PeriodicalIF":4.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592636","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":"Treatment of primary tumor in metastatic head and neck Carcinoma: A systematic review and Meta-Analysis","authors":"Fausto Petrelli ,&nbsp;Luigi Lorini ,&nbsp;Alberto Paderno ,&nbsp;Daniela Carioli ,&nbsp;Francesca Trevisan ,&nbsp;Vincenzo Capriotti ,&nbsp;Massimiliano Nardone ,&nbsp;Cristina Gurizzan ,&nbsp;Carlo Resteghini ,&nbsp;Paolo Bossi","doi":"10.1016/j.oraloncology.2025.107248","DOIUrl":"10.1016/j.oraloncology.2025.107248","url":null,"abstract":"<div><h3>Introduction</h3><div>The treatment of primary tumors in metastatic squamous cell carcinoma of the head and neck (HNSCC) is a complex and debated issue. This study evaluates the impact of treating primary tumors on overall survival (OS) and progression-free survival (PFS) in metastatic HNSCC through a systematic review and <em>meta</em>-analysis, with a focus on identifying potential biases and limitations in the available evidence.</div></div><div><h3>Materials and Methods</h3><div>A comprehensive literature search was conducted in PubMed, EMBASE, and The Cochrane Library for studies published up to January 2024. Studies comparing systemic therapy alone to systemic therapy combined with locoregional therapy targeting the primary tumor, with or without neck nodes, were included. Eligible studies reported OS or PFS outcomes in stage IV HNSCC or nasopharyngeal cancers. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using random-effects models to account for study heterogeneity.</div></div><div><h3>Results</h3><div>The <em>meta</em>-analysis included 48 studies comprising 33,637 patients. Treating the primary tumor significantly improved OS (HR = 0.55; 95 % CI, 0.49–0.61; P &lt; 0.01) and PFS (HR = 0.57; 95 % CI, 0.35–0.95; P = 0.03). However, significant heterogeneity was observed (I² = 86 %), reflecting variability in patient populations, treatment protocols, and study designs.</div></div><div><h3>Conclusions</h3><div>This <em>meta</em>-analysis suggests that treating the primary tumor in metastatic HNSCC may be associated with improved survival outcomes. However, these findings must be interpreted with caution due to significant limitations, including high heterogeneity, potential biases, and the predominance of retrospective studies.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"163 ","pages":"Article 107248"},"PeriodicalIF":4.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579424","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":"Induction chemotherapy and concurrent chemoradiotherapy with cisplatin for T4 nasoethmoidal squamous cell carcinoma: The value of paclitaxel, carboplatin and cetuximab (PCE)","authors":"Nobukazu Tanaka ,&nbsp;Tomohiro Enokida ,&nbsp;Susumu Okano ,&nbsp;Takao Fujisawa ,&nbsp;Hideki Tanaka ,&nbsp;Ryutaro Onaga ,&nbsp;Yuta Hoshi ,&nbsp;Takuma Kishida ,&nbsp;Akihisa Wada ,&nbsp;Masanobu Sato ,&nbsp;Naohiro Takeshita ,&nbsp;Takeshi Fujisawa ,&nbsp;Atsushi Motegi ,&nbsp;Sadamoto Zenda ,&nbsp;Tetsuo Akimoto ,&nbsp;Makoto Tahara","doi":"10.1016/j.oraloncology.2025.107235","DOIUrl":"10.1016/j.oraloncology.2025.107235","url":null,"abstract":"<div><h3>Background</h3><div>Locally advanced nasoethmoidal squamous cell carcinoma (SCC) is rare and often unsuitable for surgical resection. Data on the potential clinical benefits of combining induction chemotherapy (IC) and sequential definitive chemoradiotherapy for this condition is limited.</div></div><div><h3>Methods</h3><div>We retrospectively investigated T4 nasoethmoidal SCC patients who underwent proton or photon chemoradiotherapy with curative intent at the National Cancer Center Hospital East between April 2014 and May 2022. Patients were categorized into three groups based on IC regimen: no IC (No-IC), paclitaxel plus carboplatin plus cetuximab (IC-PCE), and docetaxel plus cisplatin plus S-1 (IC-TPS).</div></div><div><h3>Results</h3><div>Twenty-five patients were analyzed (No IC, 9; IC-PCE, 10; and IC-TPS, 6). The IC-PCE group had the highest ratio of Stage IVB to IVA patients. IC-PCE and IC-TPS yielded objective responses in eight (80 %) and two (33 %) patients, respectively. All subjects completed radiotherapy, with the median relative to dose intensity of concurrent cisplatin reaching 100 % in all groups. Complete responses were observed in 22 patients. Three patients in the No IC or IC-TPS group showed a partial response after the completion of planned treatment. On a median follow-up of 42 months, the 3-year recurrence-free survival (RFS) rate was 90.0 % in the IC-PCE group and 33.3 % in the remaining groups. Of note, the IC-PCE group had significantly better RFS (log-rank p-value; 0.023) despite no differences in overall survival, time-to-locoregional progression, or time-to-distant metastasis.</div></div><div><h3>Conclusion</h3><div>Sequential IC-PCE followed by concurrent chemoradiotherapy with cisplatin appears promising as an effective therapeutic strategy for T4 nasoethmoidal SCC.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"163 ","pages":"Article 107235"},"PeriodicalIF":4.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579425","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 “Hyalinizing parotid adenoid cystic carcinoma with dystrophic calcification masquerading as a thyroid-like carcinoma”","authors":"Fumio Ide,&nbsp;Shinnichi Sakamoto,&nbsp;Michiko Nishimura,&nbsp;Yuji Miyazaki,&nbsp;Kentaro Kikuchi","doi":"10.1016/j.oraloncology.2025.107233","DOIUrl":"10.1016/j.oraloncology.2025.107233","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"163 ","pages":"Article 107233"},"PeriodicalIF":4.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562491","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":"Post-treatment monitoring of surgically treated oropharyngeal squamous cell carcinoma patients using human papillomavirus cell-free DNA","authors":"Fabian Rosing ,&nbsp;Michaela Plath ,&nbsp;Tanja Proctor ,&nbsp;Daniela Höfler ,&nbsp;Yvonne Alt ,&nbsp;Carlota Lucena-Porcel ,&nbsp;Tim Waterboer ,&nbsp;Jochen Hess ,&nbsp;Karim Plath ,&nbsp;Lea Schroeder","doi":"10.1016/j.oraloncology.2025.107225","DOIUrl":"10.1016/j.oraloncology.2025.107225","url":null,"abstract":"<div><h3>Introduction</h3><div>The incidence rate of human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma (OPSCC) is increasing. Despite good prognosis, recurrence can decrease health-related quality of life and increase mortality, so post-treatment monitoring is important for patient outcomes. One potential biomarker for post-treatment monitoring is HPV cell-free DNA (cfDNA) from blood plasma.</div></div><div><h3>Methods</h3><div>Plasma samples at start of treatment and during follow-up from 27 OPSCC patients were analyzed for cfDNA of six high-risk HPV types using a multiplex digital PCR assay. Presence of HPV cfDNA was compared to HPV tumor status determined by p16^INK4a immunohistochemistry, HPV DNA, HPV RNA and HPV16 E6 serology.</div></div><div><h3>Results</h3><div>At start of treatment, sensitivity of HPV cfDNA detection in HPV-driven OPSCC cases was 89 % (17/19), while specificity was 100 % among 39 plasma samples from 8 HPV-negative OPSCC cases. A median of 4 follow-up plasma samples per patient over a mean time of 11 months were available. Positive and negative predictive values during follow-up were assessed on a per-test-basis. HPV cfDNA testing after completion of therapy had a positive predictive value of 100 % for HPV-OPSCC recurrence within one year, and a negative predictive value of 98 %. In cases of recurrent HPV-driven OPSCC, HPV cfDNA was detectable between 3 and 6.8 months before detection of recurrence by routine follow-up examination methods.</div></div><div><h3>Conclusion</h3><div>Post-treatment monitoring for early detection of recurrence could be aided by testing for HPV cfDNA in HPV-driven OPSCC patients.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"163 ","pages":"Article 107225"},"PeriodicalIF":4.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing knowledge gaps in HPV-related oropharyngeal cancer prevention: A call for action","authors":"Sarah M. Dermody ,&nbsp;Heather Walline ,&nbsp;Chandan Bhambhani ,&nbsp;Muneesh Tewari ,&nbsp;Paul L. Swiecicki ,&nbsp;Michelle Mierzwa ,&nbsp;Molly E. Heft Neal ,&nbsp;Matthew E. Spector ,&nbsp;J. Chad Brenner","doi":"10.1016/j.oraloncology.2025.107234","DOIUrl":"10.1016/j.oraloncology.2025.107234","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"163 ","pages":"Article 107234"},"PeriodicalIF":4.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551932","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":"Analysis of AI foundation model features decodes the histopathologic landscape of HPV-positive head and neck squamous cell carcinomas","authors":"Hanna M. Hieromnimon ,&nbsp;Anna Trzcinska ,&nbsp;Frank T. Wen ,&nbsp;Frederick M. Howard ,&nbsp;James M. Dolezal ,&nbsp;Emma Dyer ,&nbsp;Sara Kochanny ,&nbsp;Jefree J Schulte ,&nbsp;Cindy Wang ,&nbsp;Heather Chen ,&nbsp;Jeffrey Chin ,&nbsp;Elizabeth Blair ,&nbsp;Nishant Agrawal ,&nbsp;Ari Rosenberg ,&nbsp;Everett Vokes ,&nbsp;Rohan Katipally ,&nbsp;Aditya Juloori ,&nbsp;Evgeny Izumchenko ,&nbsp;Mark W. Lingen ,&nbsp;Nicole Cipriani ,&nbsp;Alexander T. Pearson","doi":"10.1016/j.oraloncology.2025.107207","DOIUrl":"10.1016/j.oraloncology.2025.107207","url":null,"abstract":"<div><h3>Objectives</h3><div>Human papillomavirus (HPV) influences the pathobiology of Head and Neck Squamous Cell Carcinomas (HSNCCs). While deep learning shows promise in detecting HPV from hematoxylin and eosin (H&amp;E) stained slides, the histologic features utilized remain unclear. This study leverages artificial intelligence (AI) foundation models to characterize histopathologic features associated with HPV presence and objectively describe patterns of variability in the HPV-positive space.</div></div><div><h3>Materials and Methods</h3><div>H&amp;E images from 981 HNSCC patients across public and institutional datasets were analyzed. We used UNI, a foundation model based on self-supervised learning (SSL), to map the landscape of HNSCC histology and identify the axes of SSL features that best separate HPV-positive and HPV-negative tumors. To interpret the histologic features that vary across different regions of this landscape, we used HistoXGAN, a pretrained generative adversarial network (GAN), to generate synthetic histology images from SSL features, which a pathologist rigorously assessed.</div></div><div><h3>Results</h3><div>Analyzing AI-generated synthetic images found distinctive features of HPV-positive histology, such as smaller, paler, more monomorphic nuclei; purpler, amphophilic cytoplasm; and indistinct cell borders with rounded tumor contours. The SSL feature axes we identified enabled accurate prediction of HPV status from histology, achieving validation sensitivity and specificity of 0.81 and 0.92, respectively. Our analysis subdivided image tiles from HPV-positive histology into three overlapping subtypes: <em>border</em>, <em>inflamed</em>, and <em>stroma</em>.</div></div><div><h3>Conclusion</h3><div>Foundation-model-derived synthetic pathology images effectively capture HPV-related histology. Our analysis identifies distinct subtypes within HPV-positive HNSCCs and enables accurate, explainable detection of HPV presence directly from histology, offering a valuable approach for low-resource clinical settings.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"163 ","pages":"Article 107207"},"PeriodicalIF":4.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535289","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":"Histopathological invasion patterns and prognosis in Oral Squamous Cell Carcinoma: A retrospective analysis of 560 cases","authors":"Michael Alfertshofer ,&nbsp;Leonard Knoedler ,&nbsp;Friedrich Mrosk,&nbsp;Alina Schmitz,&nbsp;Maximilian Richter,&nbsp;Carsten Rendenbach,&nbsp;Christian Doll,&nbsp;Max Heiland,&nbsp;Steffen Koerdt","doi":"10.1016/j.oraloncology.2025.107247","DOIUrl":"10.1016/j.oraloncology.2025.107247","url":null,"abstract":"<div><h3>Background</h3><div>Oral Squamous Cell Carcinoma (OSCC) remains a global health issue. Accurate histopathological assessment is vital for improving treatment outcomes. This study explores the impact of perineural, lymphatic, and vascular infiltration (Pn1, L1, V1) on OSCC progression, survival, and recurrence.</div></div><div><h3>Methods</h3><div>This retrospective study included 560 patients with primary OSCC who underwent curative surgical resection between 2012 and 2023. Data analyzed included demographics, tumor staging, histopathological features, treatment, and follow-up outcomes.</div></div><div><h3>Results</h3><div>A total of 322 males and 238 females with a mean age of 63.8 years were included. L1 was observed in 40 cases (7.1 %), Pn1 in 53 cases (9.5 %), and V1 in 4 cases (0.7 %). The mean follow-up was 29.7 months, with 3-y ear Overall Survival (OS) at 75.2 % and Recurrence-Free Survival (RFS) at 66.0 %. Multivariate logistic regression showed that contralateral lymph node metastases (CLNM) and ExtraCapsular Extension (ECE) were linked to L1 (OR: 7.83, OR: 2.52), while advanced disease and distant metastasis were strongly associated with Pn1 (OR: 12.70, OR: 6.27). Cox regression analysis revealed CLNM, ECE, and L1 were associated with reduced OS (HR: 2.32, HR: 1.82, HR: 1.90), and CLNM, ECE, L1, and poor differentiation (G3) were associated with reduced RFS (HR: 1.84, HR: 1.80, HR: 2.51, HR: 1.75). CLNM and Pn1 were strong predictors of reduced Distant Metastasis-Free Survival (DMFS).</div></div><div><h3>Conclusion</h3><div>L1 and Pn1 were associated with worse prognoses in OSCC, affecting OS, RFS, and DMFS. Research is required to clarify their roles, and including these factors in OSCC staging may improve treatment outcomes.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"163 ","pages":"Article 107247"},"PeriodicalIF":4.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elective neck dissection: Are we bound to outdated concepts?","authors":"Luca Gazzini ,&nbsp;Bianca Maria Festa ,&nbsp;Luca Calabrese","doi":"10.1016/j.oraloncology.2025.107245","DOIUrl":"10.1016/j.oraloncology.2025.107245","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"163 ","pages":"Article 107245"},"PeriodicalIF":4.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534872","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":"Efficacy of boron neutron capture therapy (BNCT) for patients with oral cancer","authors":"Jun Miyaguchi ,&nbsp;Kiyoto Shiga ,&nbsp;Katsunori Katagiri ,&nbsp;Daisuke Saito ,&nbsp;Kodai Tsuchida ,&nbsp;Takahiro Kusaka ,&nbsp;Yu Ohashi ,&nbsp;Iori Kusaka ,&nbsp;Yoshihiro Takai","doi":"10.1016/j.oraloncology.2025.107228","DOIUrl":"10.1016/j.oraloncology.2025.107228","url":null,"abstract":"<div><h3>Background</h3><div>Although BNCT is a novel therapy for head and neck cancers, its efficacy in patients with oral cancer remains unclear.</div></div><div><h3>Patients and methods</h3><div>Nine patients with oral cancer underwent BNCT at Southern Tohoku BNCT Research Center. We reviewed the charts and diagnostic images of these patients and analyzed their responses and adverse events associated with the therapy.</div></div><div><h3>Results</h3><div>All patients underwent surgery and/or radiotherapy as initial treatment for head and neck cancer. No patients had distant metastases at the time of BNCT. The median observation period was 16 months. Grade 3 and 4 adverse events were observed in six patients who recovered within one month. Treatment responses were complete in seven patients and partial in two. Overall survival, disease-specific survival, and local control rates of the patients at one year were 76.2, 76.2, and 87.5 %, respectively.</div></div><div><h3>Conclusion</h3><div>Our study suggested that BNCT is a relatively safe and effective treatment for patients with recurrent and/or advanced oral cancer.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"163 ","pages":"Article 107228"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521251","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}