Seminars in oncology最新文献

{"title":"Colorectal cancer in Ethiopia: Epidemiological trends, diagnostic and laboratory capacities, and challenges","authors":"Gashaw Getaneh Dagnaw ,&nbsp;Haileyesus Dejene","doi":"10.1053/j.seminoncol.2024.09.002","DOIUrl":"10.1053/j.seminoncol.2024.09.002","url":null,"abstract":"<div><div>Colorectal cancer (CRC) refers to cancer that develops in the colon or rectum, parts of the large intestine. It ranks as the third most prevalent form of cancer globally. Colorectal cancer is responsible for the morbidity of millions and the loss of hundreds of thousands of lives worldwide although the incidence varies significantly depending on geographical location. In recent years, CRC has decreased in high-income countries due to technological advancements in diagnosis and treatment. However, there is an increased occurrence of CRC morbidity and mortality in low- and middle-income countries. Colorectal cancer is becoming an emerging public health concern in Ethiopia. We noticed that the incidence rates have been lower compared to more developed countries, but recent years have seen a noticeable increase. This rise is attributed to factors such as changes in diet, lifestyle, and an aging population. Common risk factors include dietary shifts towards processed foods and red meat, physical inactivity, obesity, smoking, and alcohol consumption. Unfortunately, in Ethiopia, screening programs for CRC are not widespread, and limited access to diagnostic facilities, lack of public awareness, and insufficient healthcare infrastructure contribute to late-stage diagnoses or left without diagnosis. Treatment options, including surgery, chemotherapy, and radiotherapy, are available but not uniformly accessible across the country, posing challenges for timely and effective treatment. Addressing colorectal cancer in Ethiopia requires a comprehensive approach to enhance public awareness, improve screening and early detection, expand treatment facilities, and train healthcare professionals to provide effective care.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"52 1","pages":"Pages 19-26"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The critical role of NLRP3 in drug resistance of cancers: Focus on the molecular mechanisms and possible therapeutics","authors":"Beena Briget Kuriakose ,&nbsp;Ahmed Hussein Zwamel ,&nbsp;Ayad Abdulrazzaq Mutar ,&nbsp;Subasini Uthirapathy ,&nbsp;Ashok Kumar Bishoyi ,&nbsp;K. Satyam Naidu ,&nbsp;Ahmed Hjazi ,&nbsp;Prashant Nakash ,&nbsp;Renu Arya ,&nbsp;Sami G. Almalki","doi":"10.1016/j.seminoncol.2025.152337","DOIUrl":"10.1016/j.seminoncol.2025.152337","url":null,"abstract":"<div><div>Nod-like receptor protein 3 (NLRP3) is a member of the leucine-rich repeat-containing protein (NLR) canonical inflammasome family. It regulates the pathophysiology of cancer by facilitating immune responses and apoptotic proteins. Furthermore, it has been observed that chemotherapy activates NLRP3 in human malignancies. The secretion of IL-1β and IL-22 to promote cancer spread may be triggered by NLRP3 activation. Furthermore, earlier studies have exhibited that NLRP3 may cause medication resistance when used in cancer treatments given that cell viability may be regulated by NLRP3 depletion. Additionally, clinical studies have demonstrated correlation between NLRP3 expression, lymphogenesis, and cancer metastasis. Various NLRP3 agonists may cause the EMT process, stimulate IL-1β and Wnt/β-catenin signaling, and alter miRNA function in drug-resistant cells. This review seeks to clarify the possibility involvement of NLRP3-related pathways in the control of cancer cells' resistance to widely used treatment approaches, such as chemotherapy. In the end, an improved perception of the corresponding mechanisms behind NLRP3′s tumor-supporting activities will help NLRP3-based treatments advance in the future.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"52 1","pages":"Pages 27-40"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-Based Differences in the Efficacy of Anti-EGFR/BRAF/MEK Targeted Therapy in Patients with BRAF-Mutated Metastatic Colorectal Cancer","authors":"Laura Pala MD ,&nbsp;Tommaso De Pas MD ,&nbsp;Emilia Cocorocchio MD ,&nbsp;Chiara Catania MD ,&nbsp;Giovanni Ceresoli MD ,&nbsp;Daniele Laszlo MD ,&nbsp;Emma Zattarin MD ,&nbsp;Giovanna Rossi MD ,&nbsp;Fabio Conforti MD","doi":"10.1053/j.seminoncol.2024.10.004","DOIUrl":"10.1053/j.seminoncol.2024.10.004","url":null,"abstract":"<div><h3>Objectives</h3><div>We previously showed that men with melanoma harboring BRAF mutations had significantly lower benefit from targeted therapy as compared with women Here we explored the hypothesis that such gender-based dimorphism in the efficacy of BRAF-pathway blockade extends to other tumor histotypes carrying pathogenic BRAF-mutations.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from a cohort of patients with advanced colorectal-cancer (CRC) harboring BRAF V600E mutations, treated with anti-EGFR/BRAF/MEK targeted therapy. The primary objective was to assess the association between gender and outcome of patients treated with targeted therapy, in terms of overall response rate (ORR), progression-free survival (PFS) and overall survival (OS).A multivariable Cox proportional hazard regression model was used to assess the association between gender and PFS and OS, adjusted for other relevant clinical, pathological and molecular prognostic factors, including ECOG PS (0 vs 1-2), primary tumor site (right-side vs left-side), microsatellite instability status (instable [MSI] vs stable [MSS]), number of metastatic sites at treatment start, treatment type (double targeted therapy [ie, anti-EGFR + anti-BRAF] vs triple targeted therapy [ie, anti-EGFR + anti-BRAF + anti-MEK]) and mutational status of the RNF43 gene (wild type vs mutated).</div></div><div><h3>Results</h3><div>Ninety-eight patients with advanced CRC were included in the analysis: 59 (60%) were women and 39 (40%) men. The ORR was 43.1% in women vs only 23.7% in men (<em>p</em>-value = .05). Multivariable analysis adjusted for relevant clinical, pathological, and molecular variables associated with patients’ prognosis, showed a significantly shorter PFS and OS in men as compared with women: the adjusted-HR was, respectively, 1.65 (95%CI,1.00-2.69; <em>p</em> = .04) for PFS and 1.83 (95%CI,1.08-3.08; <em>p</em>-value = .02) for OS.</div></div><div><h3>Conclusions</h3><div>We confirmed a significant gender-based dimorphism in the efficacy of anti-EGFR/BRAF/MEK therapy in patients with advanced-CRC harboring BRAF mutations that warrant further investigation.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"52 1","pages":"Pages 10-13"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity correlates to the microsatellite instability of endometrial cancer: A retrospective observational study","authors":"Carlo Ronsini ,&nbsp;Eleonora Braca ,&nbsp;Mario Fordellone ,&nbsp;Federica Zito Marino ,&nbsp;Stefania Napolitano ,&nbsp;Antonio Raffone ,&nbsp;Luigi Cobellis ,&nbsp;Pasquale De Franciscis","doi":"10.1053/j.seminoncol.2025.01.001","DOIUrl":"10.1053/j.seminoncol.2025.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the relationship between obesity and Microsatellite Instability (MSI) in endometrial cancer (EC), determine which mismatch repair (MMR) protein loss is influenced by obesity, and assess the correlation between BMI and MSI probability.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 89 endometrial cancer patients treated at the Gynaecologic oncology unit of the University of Campania “Luigi Vanvitelli” from August 2023 to October 2024, and stratified by BMI: normal weight (<em>n</em> = 26), overweight (<em>n</em> = 31), obese (<em>n</em> = 26), and severely obese (<em>n</em> = 6). Microsatellite instability (MSI) was determined through immunohistochemical assessment of mismatch repair (MMR) protein expression: MLH1, PMS2, MSH2, and MSH6. Tumors were considered MSI if at least one of the four MMR proteins showed loss of expression. Univariate and multivariate logistic regression models were constructed to evaluate the correlation between BMI and MSI</div></div><div><h3>Results</h3><div>89 patients were enrolled. Obese and severely obese groups showed significantly higher MSI rates (50 % each) compared to normoweight (12 %) and overweight (29 %) groups (<em>P</em> = .013). MLH1 and PMS2 loss of expression were significantly higher in obese and severely obese women (MLH1: <em>P</em> = .003; PMS2: <em>P</em> = .014). Univariate logistic regression showed a significant positive correlation between BMI and MSI (OR 1.02, 95 % CI 1.01–1.04, <em>P</em> = .007). In multivariate analysis, adjusting for grading, stage, histotype, and age, BMI maintained a significant positive correlation with MSI (OR 1.02, 95 % CI 1.01–1.04, <em>P</em> = .048).</div></div><div><h3>Conclusions</h3><div>This study demonstrates a significant association between obesity and MSI in EC, particularly affecting MLH1 and PMS2 expression. The findings suggest that obesity may contribute to EC development also through MMR deficiency.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"52 1","pages":"Pages 1-6"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143478638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The likelihood of being helped or harmed obtained from clinical trial results for cancer therapy: Can it really help?","authors":"Giuseppe Bronte","doi":"10.1053/j.seminoncol.2024.12.001","DOIUrl":"10.1053/j.seminoncol.2024.12.001","url":null,"abstract":"<div><div>The majority of cancer clinical trials leading to therapeutic approval focus on outcomes such as objective tumor responses, progression-free survival (PFS), and overall survival (OS). However, it is equally important to assess toxicity, especially when comparing standard therapies with experimental ones. Clinical trials often fail to synthesize the relationship between efficacy and adverse event frequency, partly due to differences in measurement units. To address this, the number needed to treat (NNT) and number needed to harm (NNH) can be used as standardized measures. NNT represents the number of patients required to benefit from a treatment, while NNH indicates the number needed to experience harm. These metrics allow for a more balanced evaluation of therapeutic efficacy and toxicity. By calculating NNT for PFS or OS and NNH for adverse events, we can assess the therapeutic benefit relative to potential harm. The likelihood of being helped or harmed (LHH) combines these metrics into a ratio that expresses the balance between benefit and toxicity. Ideally, LHH values greater than 1 indicate a favorable balance toward efficacy. Though LHH has been applied mainly to psychotropic drugs, it was used in oncology sometimes. For example, studies in advanced non–small cell lung cancer and breast cancer have demonstrated LHH's utility in comparing treatments. Whereas LHH calculation has some limitations, it offers a valuable tool for explaining treatment risks and benefits to patients. It also could guide clinical trial design in cancer therapy.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"52 1","pages":"Pages 7-9"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemotherapy plus immunotherapy as first line combination in older patients with extensive stage small cell lung cancer: A systematic review and meta-analysis","authors":"Valentina Bertaglia ,&nbsp;Fausto Petrelli ,&nbsp;Lorenzo Dottorini ,&nbsp;Simona Carnio ,&nbsp;Anna Maria Morelli ,&nbsp;Alessandro Nepote ,&nbsp;Antonio Maccioni ,&nbsp;Mario Scartozzi ,&nbsp;Cinzia Solinas ,&nbsp;Silvia Novello","doi":"10.1053/j.seminoncol.2024.11.001","DOIUrl":"10.1053/j.seminoncol.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Small-cell lung cancer (SCLC) accounts for 10%–15% of all lung cancers. At diagnosis, nearly two thirds of patients with SCLC have extensive stage (ES), with a median overall survival (OS) less than 12 months. The combination of protein-death-1/protein-death-ligand-1 (PD-1/PD-L1) immune checkpoint inhibitors (ICIs) with first-line platinum plus etoposide chemotherapy has changed the therapeutic landscape for ES-SCLC. Older adults represent most of the cancers diagnosed and deaths by age group, with an expected increase over the next decade. In the real-world setting, about 30%–40% of patients with a diagnosis of SCLC are reported to be over 70-years-old at the time of diagnosis. However, this subgroup of patients is underrepresented in clinical trials. Based on this evidence, we performed this systematic review to define the activity of ICIs plus chemotherapy in older patients with previously untreated ES-SCLC.</div></div><div><h3>Methods</h3><div>This systematic review was carried out in accordance with the statement in the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search on multiple electronic databases was conducted from inception to the end of April to identify randomized trials that prospectively evaluated chemotherapy <span><math><mo>±</mo></math></span> PD-1/PD-L1 ICIs. When more than one report of the same study was available, the most recent data (with longer follow-up and/or higher number of patients) was considered. The primary endpoint of the study was efficacy, in terms of overall survival, progression-free survival, and disease control rate.</div></div><div><h3>Results</h3><div>We selected six randomized clinical trials that enrolled 3396 patients in the meta-analysis. In the experimental arm, 670 patients were 65 years of age and older compared to 504 in the control arm. In the subgroup of patients ≥65 years, adding ICIs to chemotherapy led to a significant benefit in OS [hazard ratio (HR) 0.80, 95% confidence interval (CI) 0.72-0.90). There was moderate but not-significant heterogenity among the trials (I² = 47%, <em>P</em> = 0.07).</div></div><div><h3>Conclusion</h3><div>This systematic review found that the combination of chemotherapy plus ICIs improved OS among older patients with ES-SCLC. Biomarker and comprehensive geriatric assessment are needed to improve the identification and selection of patients with cancer that are uniformly defined as older.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"52 1","pages":"Pages 14-18"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pioneering the Future of Oncology: A New Vision for Seminars in Oncology","authors":"","doi":"10.1053/S0093-7754(25)00032-6","DOIUrl":"10.1053/S0093-7754(25)00032-6","url":null,"abstract":"","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"52 1","pages":"Pages iv-v"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adenocarcinoma on retrorectal cystic hamartoma: An illustrative image for a very rare diagnosis","authors":"José Felipe Reoyo Pascual,&nbsp;Evelio Alonso Alonso,&nbsp;Lucia Polanco Pérez,&nbsp;Miguel Álvarez Rico","doi":"10.1053/j.seminoncol.2024.10.003","DOIUrl":"10.1053/j.seminoncol.2024.10.003","url":null,"abstract":"<div><div>Retrorectal cystic hamartoma (also known as tailgut cyst) is a congenital lesion that originates from debris from the embryonic caudal intestine. Incidentally diagnosed in more than half of cases, the treatment of choice is surgical resection. It is a very rare pathology whose oncological transformation constitutes a true pathological rarity.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"51 5","pages":"Pages 154-155"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated profile of tumor stage and mutational burden predicts disparate clinical responses to immune checkpoint inhibitors: A risk-benefit study","authors":"Ming Zheng MD, PhD","doi":"10.1053/j.seminoncol.2024.08.003","DOIUrl":"10.1053/j.seminoncol.2024.08.003","url":null,"abstract":"<div><div>Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, having demonstrated efficacy and leading to regulatory approvals of ICIs in cancers characterized by high tumor mutation burden (TMB). However, there remains a gap in determining their applicability and risk-benefit profile, across the broad spectrum of patients whose tumors harbor varying TMB levels across distinct tumor stages. By interrogating a large contemporary cohort comprised of 10,233 patients with a diagnosis of cancer across all tumor stages and TMB levels, this study revealed significantly improved overall survival (OS) following ICI therapy (<em>P</em> &lt; .0001) in patients with a combination of <span><math><mo>≥</mo></math></span>10 mut/Mb and stage IV disease. In contrast, ICI therapy is associated with markedly worse OS in patients with low TMB levels &lt;10 mut/Mb and stages I, II, and III cancer. These findings highlight the critical interplay between TMB, tumor stage, and ICI treatment outcomes, underscoring the importance of integrating clinical and genetic characteristics in weighing the risk-benefit balance of ICI therapy. Although maximizing therapeutic benefits is crucial, it is equally important to identify and manage potential risks that may not be immediately apparent. This may require enrolling patients with less-severe or early-stage disease to enable long-term follow‐up with effective clinical surveillance. By comprehensively evaluating the added benefit of improved treatment efficacy and the potential risk of adverse treatment outcome, a risk-benefit profile can optimize immunotherapy regimens, with profound implications for clinical decision-making and regulatory approvals of ICI.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"51 5","pages":"Pages 142-148"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening Adherence for Second Primary Malignancies in Breast Cancer Survivors: Behaviors, Facilitators, and Barriers to Enhance Quality Care","authors":"Fernanda Mesa-Chavez ,&nbsp;Misael Salazar-Alejo ,&nbsp;Cynthia Villarreal-Garza","doi":"10.1053/j.seminoncol.2024.10.005","DOIUrl":"10.1053/j.seminoncol.2024.10.005","url":null,"abstract":"<div><div>Due to genetic, hormonal, and environmental factors, alongside increased life expectancy, breast cancer (BC) survivors have an increased risk of developing a second primary malignancy. Therefore, regular screening for other types of cancer is of utmost importance for their comprehensive care. This cross-sectional study evaluated BC survivors’ compliance with cervical, lung, and colorectal cancer screening, and identified facilitators and barriers influencing adherence. Fifty-two BC survivors answered the study's survey. A total of three (6%) cases of second primary malignancies were self-reported. Cervical cancer screening was performed within the past 3 years among 37/50 (74%) eligible participants. Only 7/24 (29%) eligible participants underwent colorectal cancer screening within the last 10 years, including six colonoscopies and 1 occult blood test. No participant had an indication for lung cancer screening. The primary reason for noncompliance with both cervical and colorectal cancer screening was lack of physician's recommendation, accounting for 79% and 88% of cases, respectively. Nearly all participants (98%) affirmed that BC survivors should undergo screening for other types of cancer. Most (96%) stated that, if recommended by a physician, they would agree to undergo screening for other neoplasms. Even though most BC survivors acknowledged its importance, screening particularly for colorectal cancer exhibited suboptimal rates. Oncologists could play a crucial role in increasing cancer screening uptake by reminding patients of their corresponding recommendations to detect other types of cancer.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"51 5","pages":"Pages 156-160"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}