Revista de Senologia y Patologia Mamaria最新文献

{"title":"La reconstrucción posmastectomía y su relación con la radioterapia adyuvante en el tratamiento del cáncer invasivo de mama: ¿asunto cerrado?","authors":"Irene Císcar García ,&nbsp;Isabel de la Fuente Muñoz ,&nbsp;Pilar Sánchez Henarejos ,&nbsp;Pedro Marín Rodríguez ,&nbsp;Caridad Marín Hernández ,&nbsp;Carmen María Servet Pérez de Lema ,&nbsp;Jose Luis Alonso Romero ,&nbsp;Antonio Piñero Madrona","doi":"10.1016/j.senol.2024.100617","DOIUrl":"10.1016/j.senol.2024.100617","url":null,"abstract":"<div><h3>Introduction</h3><p>Post-mastectomy radiotherapy is vital in the treatment of breast cancer because it improves survival. Post-mastectomy breast reconstruction impacts quality of life, but adjuvant radiotherapy is controversial, due to the complications it entails. This study examines the relationship between radiotherapy and the complications in reconstruction, with consideration of the moment in time and the technique employed.</p></div><div><h3>Methods</h3><p>A single-centre, retrospective study was conducted with 273 patients treated with mastectomy and reconstruction. Radiotherapy was assessed as an independent variable in relation to its complications. Demographic, anatomopathological, surgical and treatment variables were analysed.</p></div><div><h3>Results</h3><p>The general rate of complications was 42.2%, with fat necrosis and capsular contracture being the most common. There was no significant relationship between radiotherapy and complications in general, but there was a trend towards more complications with immediate reconstructions. Autologous reconstruction was associated with fewer complications than heterologous, particularly with radiotherapy.</p></div><div><h3>Discussion</h3><p>Although previous studies suggest there is an association between radiotherapy and morbidity in post-mastectomy reconstruction, this study did not find any direct connection. The importance of distinguishing between complications at the donor and recipient sites stood out. Immediate reconstruction demonstrated a larger number of complications with radiotherapy, supporting the recommendation to postpone it. Autologous reconstruction was highlighted as the preferred option.</p></div><div><h3>Conclusions</h3><p>The study did not find a direct association between radiotherapy in post-mastectomy reconstruction patients and complications in general. However, it revealed a correlation between complications and heterologous techniques, emphasising the preference for autologous reconstructions.</p></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"37 4","pages":"Article 100617"},"PeriodicalIF":0.3,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141979278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is neoadjuvant treatment indicated in triple negative cT1N0 breast cancer?","authors":"Esmeralda García-Torralba ,&nbsp;Noel Blaya Boluda ,&nbsp;María Esperanza Guirao García ,&nbsp;Elisa García Garre ,&nbsp;Francisco Ayala de la Peña","doi":"10.1016/j.senol.2024.100613","DOIUrl":"10.1016/j.senol.2024.100613","url":null,"abstract":"<div><p>Triple negative breast cancer (TNBC) is the most aggressive subtype, including early BC. Neoadjuvant chemotherapy (NAC) has shown benefit in achieving more conservative surgeries, but also it is useful to determine therapeutic sensitivity, prognostic estimation, and consequent choice of an individualized adjuvant treatment. Traditionally, NAC was indicated in patients with cT2 (2 cm or more) TNBC. However, recent guidelines consider neoadjuvant treatment for cT1 TNBC patients. In this paper, we review the current evidence on neoadjuvant treatment in cT1 TNBC patients, including available signals on efficacy, choice of optimal regimen and identification of patients with the greatest potential benefit.</p></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"37 4","pages":"Article 100613"},"PeriodicalIF":0.3,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimización del diagnóstico y estadificación TNM del cáncer de mama en acto único desde el servicio de radiología: protocolo TEMA","authors":"Florentina Guzmán-Aroca,&nbsp;Ana Azahara García-Ortega,&nbsp;Josefa Pérez-Templado,&nbsp;Juan Francisco Martínez-Martínez,&nbsp;Francisco Sarabia-Tirado,&nbsp;José Luis Alonso-Romero,&nbsp;Antonio Piñero-Madrona","doi":"10.1016/j.senol.2024.100610","DOIUrl":"10.1016/j.senol.2024.100610","url":null,"abstract":"<div><h3>Introduction</h3><p>After histological confirmation, mammography, ultrasound (including nodal territory), and MRI are used for locoregional staging. Tests such as computed tomography (CT) are used for the study of distant metastases.</p></div><div><h3>Methods</h3><p>Prospective randomized controlled study with 44 patients (September 2022 to March 2023), studied by initial directed ultrasound with: breast nodules suspicious for malignancy (BNSM) &gt;<!--> <!-->5 cm or associated breast inflammation, BNSM with lymphadenopathy (axillary/internal mammary region), or lymphadenopathy in axillary/internal mammary region without nodule. Half followed the usual protocol and the other half the TEMA protocol (thoraco-abdominal-pelvic CT and mammography with contrast with the same bolus of intravenous contrast, 2 phases, tomosynthesis and ultrasound with biopsies; all in a single act).</p></div><div><h3>Results</h3><p>There were no significant differences in age, stage, tumor type, or immunophenotype between the two groups. With the usual protocol, the mean time from biopsy of lesions with suspected malignancy to staging CT scan, or Total Delay Time (TDT) was 40 days, and all had started neoadjuvant chemotherapy. The median time required for diagnóstico and staging with the TEMA protocol was 27 min.</p></div><div><h3>Conclusions</h3><p>Initial targeted ultrasound identifies patients who will benefit from initial locoregional and distant staging, candidates for the TEMA protocol. This allows immediate complete staging, which is more accurate (without modifications due to chemotherapy), and eliminating TDT.</p></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"37 4","pages":"Article 100610"},"PeriodicalIF":0.3,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor phyllodes maligno asociado a carcinoma ductal infiltrante de la mama, descripción de un caso tratado en nuestro centro","authors":"María Valvanera Garcia Moreno,&nbsp;Claudia Bagur Bagur,&nbsp;Fernando Alcaide Matas","doi":"10.1016/j.senol.2024.100612","DOIUrl":"10.1016/j.senol.2024.100612","url":null,"abstract":"<div><p>The association of Phyllodes tumor with malignant epithelial neoplasms is very rare, which is why the presentation of a case recently treated in our unit is of interest. This article describes our experience in the diagnosis and treatment of a 72-year-old patient diagnosed with a Phyllodes tumor of the breast associated with a triple-negative infiltrating ductal carcinoma and aims to draw attention to this very rare association. The association of Phyllodes tumor and carcinoma occurs in only 1–2% of all phyllodes tumors. Types of carcinomas include carcinoma <em>in situ</em>, invasive forms ductal, lobular, tubular and squamous carcinoma, with the ductal phenotype being the most frequently related usually located inside or adjacent to the phyllodes tumor, since the carcinoma originates from the epithelial component of this tumor. Detecting the carcinomatous component prior to surgical intervention is very difficult, being diagnosed in most cases in the definitive pathological study. The main treatment is surgery with wide margins, sometimes combining SLNB, if it is associated with a carcinoma. A detailed analysis of tumor characteristics with reference to molecular subtype and pathological features should be performed to select the optimal treatment strategy for Phyllodes tumor-associated carcinoma.</p></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"37 4","pages":"Article 100612"},"PeriodicalIF":0.3,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conservative treatment versus mastectomy for breast ductal carcinoma in situ: outcomes and quality of life","authors":"Beatriz Gil Haro ,&nbsp;Cristina de la Fuente Alonso ,&nbsp;Sofía Córdoba Largo ,&nbsp;Joaquín Velasco Jiménez ,&nbsp;Marta López Valcárcel ,&nbsp;Raquel Benlloch Rodríguez ,&nbsp;María Esther Ramírez Medina ,&nbsp;Mariano Artés Casellés ,&nbsp;Cesáreo Corbacho Cuevas ,&nbsp;María Carmen Vega Carrasco ,&nbsp;José Ramón Castelló Fortet ,&nbsp;Irma Zapata Paz ,&nbsp;María Hernández Miguel ,&nbsp;Sofía Santana Jiménez ,&nbsp;María Isabel García Berrocal ,&nbsp;Jaime Ricardo Gómez Jaramillo ,&nbsp;Francisco Javier Martínez Paredes ,&nbsp;Sara Pérez Mata ,&nbsp;Jesús Romero Fernández","doi":"10.1016/j.senol.2024.100611","DOIUrl":"https://doi.org/10.1016/j.senol.2024.100611","url":null,"abstract":"<div><h3>Introduction</h3><p>Ductal carcinoma in situ (DCIS) accounts for 20% of new breast cancer diagnoses. Treatment includes breast-conserving surgery (BCS) with or without radiation therapy (RT), mastectomy, and sentinel lymph node biopsy. Surgical decisions depend on the centre's policy and patient choice. We aimed to compare outcomes and quality-of-life (QoL) between treatment with BCS<!--> <!-->+<!--> <!-->RT or mastectomy in patients with breast DCIS.</p></div><div><h3>Methods</h3><p>We conducted a retrospective study of 155 patients with DCIS from January 2009 to December 2018. Among them, 83 were treated with mastectomy and 72 with BCS<!--> <!-->+<!--> <!-->RT. Disease-free survival (DFS), local-recurrence-free survival, and overall survival (OS) were recorded. Statistics: Kaplan–Meier, log rank.</p></div><div><h3>Results</h3><p>Median follow-up was 82 months (33–152). Five- and 10-year DFS were 93% and 91%, respectively. There were no differences in DFS rate between the 2 groups (9.6% vs 6.9%, <em>p</em> <!-->=<!--> <!-->.38). OS rates at 5- and 10-years was 100% in both groups. Larger tumours were associated with a higher contralateral DCIS relapse (47.3 mm vs 19.3 mm, <em>p</em> <!-->=<!--> <!-->.004). In mastectomy group, patients with tumour size &gt;<!--> <!-->2 cm had a worse 5- and 10-years DFS than patients with smaller tumours (<em>p</em> <!-->=<!--> <!-->.019). In terms of QoL, there was no difference between the 2 treatment groups.</p></div><div><h3>Conclusion</h3><p>BCS<!--> <!-->+<!--> <!-->RT and mastectomy offer similar clinical outcomes and QoL. Our results demonstrate that BCS is a viable option even for patients with larger tumours. These findings serve as a guide for clinical decision-making to optimise the management of DCIS.</p></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"37 4","pages":"Article 100611"},"PeriodicalIF":0.3,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efecto de la cirugía bariátrica en el riesgo de cáncer de mama. Evaluación de la calidad de los metaanálisis","authors":"Mario Arturo González Mariño","doi":"10.1016/j.senol.2024.100609","DOIUrl":"https://doi.org/10.1016/j.senol.2024.100609","url":null,"abstract":"<div><h3>Introduction</h3><p>Obesity is considered a risk factor for breast cancer in postmenopausal women. Some meta-analyses report the reversal of this risk with bariatric surgery. However, the methodological quality of these studies is unknown. To evaluate systematic reviews that include non-randomized studies, the AMSTAR 2 tool is used.</p></div><div><h3>Objective</h3><p>To evaluate the quality of meta-analyses examining the effects of bariatric surgery on breast cancer risk.</p></div><div><h3>Materials and methods</h3><p>A systematic review of meta-analysis studies was performed using the search terms “Obesity surgical procedures and Breast Neoplasms” in the PubMed, Embase, Scopus and Cochrane Database of Systematic Reviews databases. The finally selected meta-analyses were scored with the AMSTAR 2 assessment tool.</p></div><div><h3>Results</h3><p>The database searches found 87 articles, of which, after selection and complete reading of the articles, six were finally extracted for qualitative analysis. Meta-analyses reviewed using the AMSTAR 2 assessment tool found that overall confidence in the results was critically low.</p></div><div><h3>Conclusions</h3><p>Meta-analyses showed an association between bariatric surgery and a lower risk of developing breast cancer. However, all of them have important limitations. Evaluation using the AMSTAR-2 assessment tool showed that overall confidence in the results of the studies evaluated was critically low.</p></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"37 4","pages":"Article 100609"},"PeriodicalIF":0.3,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141595970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HER2DX: avances en el tratamiento individualizado del cáncer de mama HER2-positivo","authors":"Juan M. Cejalvo Andújar","doi":"10.1016/j.senol.2024.100615","DOIUrl":"10.1016/j.senol.2024.100615","url":null,"abstract":"","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"37 3","pages":"Article 100615"},"PeriodicalIF":0.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141637642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descripción de un caso: ¿es factible realizar una biopsia selectiva de ganglio centinela en tumores de mama originados en el tejido ectópico axilar?","authors":"Javier Martínez Portillo ,&nbsp;Cándida Correa Orbán ,&nbsp;Victoria Sampayo Montenegro","doi":"10.1016/j.senol.2024.100607","DOIUrl":"https://doi.org/10.1016/j.senol.2024.100607","url":null,"abstract":"<div><p>Breast cancer on axillary ectopic breast tissue is very rare, representing 0.3-0.6% of malignant breast cancers. Therefore, its early diagnosis is a real challenge. In this case, we describe a breast cancer on left axillary ectopic tissue in a 36-year-old female patient, who underwent local surgery with excision of the tissue. When approaching the nodal study of this patient, the possibility of selective study of the sentinel lymph node was considered. The absence of validated clinical guidelines in these cases and the exhaustive review of the literature led the multidisciplinary tumour committee of our hospital, the Hospital Clínico de Santiago de Compostela, to adopt the decision to attempt to perform this technique, adapting it, however, to this particular case. A double tracer was used, injecting technetium-99m in the periareolar area of the left breast and patent blue in the intratumoral area of the axillary ectopic tissue to determine whether both the breast and the tumour had the same lymphatic drainage pathways.</p><p>Finally, 7 sentinel nodes and 1 palpable non-sentinel node were detected, of which the first was marked with both technetium-99m and patent blue, 4 with the radioisotope only, and 2 stained with patent blue. Two macrometastases were detected intraoperatively in the sentinel nodes, stained only with patent blue, while the rest were negative. The tumour committee took the decision to treat the axilla with radiotherapy. It is therefore concluded that in these cases the periareolar lymphatic drainage and that of the tumour itself may be different, so it would be advisable to use the double tracer injected in different areas to correctly identify the sentinel lymph node. The literature available for this type of situation is scanty and there are no approved clinical guidelines to support our therapeutic decisions, so it would be essential to study breast cancer in infrequent locations, in depth, in order to achieve protocols standardised by international societies that would serve as a benchmark for the management of these cases.</p></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"37 4","pages":"Article 100607"},"PeriodicalIF":0.3,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Description of a case: merkel cell carcinoma in a male nipple after a kidney and liver transplant","authors":"Juan-Manuel Morón-Ocaña ,&nbsp;Isabel-María Coronel-Pérez ,&nbsp;María Rodríguez de la Borbolla Atacho","doi":"10.1016/j.senol.2024.100606","DOIUrl":"https://doi.org/10.1016/j.senol.2024.100606","url":null,"abstract":"<div><p>Primary Merkel cell carcinoma (MCC) is rare primary neuroendocrine skin carcinoma that arises most commonly on sun-damaged skin of elderly or immunosuppressed patients. Breast involvement is even rarer with incidence under 0.1% of all breast carcinomas. To our knowledge, only eight cases of primary MCC of the breast have been reported in the literature and seven of them were in female patients. We present the second case of primary MCC described in a male breast so far. A 61-year-old male presented for evaluation of a mass in the left nipple. He presented a double kidney and liver transplant in 2014 due to an hepatocarcinoma. The patient was definitively diagnosed as unresectable locally advanced MCC. MCC risk is sharply elevated after solid organ transplant, likely resulting from long-term immunosuppression. MCC should be suspected in the presence of a rapidly amelanotic growing mass in the breast.</p></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"37 3","pages":"Article 100606"},"PeriodicalIF":0.3,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disección axilar dirigida tras tratamiento sistémico primario en cáncer de mama N1. Validación de la técnica y experiencia a los 4 años","authors":"Giovanni Vento ,&nbsp;Carlos Fuster ,&nbsp;Vincenzo Maisto ,&nbsp;Alberto Rios ,&nbsp;Joaquin Gavilá ,&nbsp;Angel Guerrero ,&nbsp;Salvador Blanch ,&nbsp;Rosa Ferrer ,&nbsp;Josep Asensi ,&nbsp;María Elena Mengual ,&nbsp;Seyder Morales ,&nbsp;Miguel Santos ,&nbsp;Maribel Tortajada ,&nbsp;José Luis Guinot ,&nbsp;Rafael Estevan","doi":"10.1016/j.senol.2024.100605","DOIUrl":"https://doi.org/10.1016/j.senol.2024.100605","url":null,"abstract":"<div><h3>Objectives</h3><p>To assess the omission of systematic axillary lymphadenectomy (ALND) in patients with N1 breast cancer with axillary pathological response (APR) after primary systemic treatment (PST). Description and experience of the Technique: Target Axillary Dissection TAD. Identify which subtypes are associated with higher APR.</p></div><div><h3>Patients and methods</h3><p>A descriptive, retrospective study of 90 patients with cT1-T3/N1/M0 stage breast carcinoma who received TSP at the Valencian Institute of Oncology (IVO), between January 2020 and December 2023; 63 received chemotherapy and/or anti-HER2 therapy and 27 received hormonal therapy. Biopsy and labeling of the suspicious lymph node (maximum 3) were performed. In the surgery, a harpoon was placed in the axillary lymph node and the sentinel lymph node (BSGC) technique was also performed with technetium-99m and methylene blue.</p></div><div><h3>Results</h3><p>APR was achieved in 46/90 cases (51.2%), in 30/46 (65.2%) pCR, and in 16/46 ITC (isolated tumor cells) or micrometastases remained. Macrometastases were observed in 44/90 (48.8%) and therefore ALND or axillary Rt was performed. There have been no axillary or distant relapses. Detection of the marked node: 100%. RPA occurred in: Luminal A, 26%; Luminal B, 42%; HER2-positive, 86% and Triple Negative, 66%.</p></div><div><h3>Conclusions</h3><p>In the IVO, ADT is a feasible technique. More than 50% of the cohort had an APR avoiding ALND. The HER2-positive and triple negative subtypes have the highest response rate. It is an oncologically safe procedure; NOT less than ALND.</p></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"37 3","pages":"Article 100605"},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141423640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}