Annals of Diagnostic Pathology最新文献

{"title":"B/T mixed phenotype acute leukemia revealing immunophenotypic lineage-genotype associations and frequent myelodysplasia-related cytogenetic/gene abnormalities: implication for diagnosis and treatment","authors":"Lina Han,&nbsp;Van Tuong Nguyen,&nbsp;Ruifang Zheng,&nbsp;Franklin Fuda,&nbsp;Miguel D. Cantu,&nbsp;Prasad Koduru,&nbsp;Jesse M. Jaso,&nbsp;Olga K. Weinberg,&nbsp;Sharon Germans,&nbsp;Mingyi Chen,&nbsp;Jing Xu,&nbsp;Weina Chen","doi":"10.1016/j.anndiagpath.2025.152540","DOIUrl":"10.1016/j.anndiagpath.2025.152540","url":null,"abstract":"<div><div>B/T mixed-phenotype acute leukemia (MPAL) is a rare subtype of leukemia with diagnostic and therapeutic challenges due to its rarity, genomic diversity, and evolving diagnostic criteria. We report six cases of B/T MPAL with clinicopathological and genomic characterization. Most cases (5/6) demonstrated immunophenotypic/lineage-genotype-associations, i.e., T-lineage predominant B/T MPAL with T-lymphoblastic leukemia (T-ALL) genotype whereas B/T-lineage codominant B/T MPAL with combined T-ALL/B-ALL genotype. Furthermore, most patients (5/6) carried myelodysplasia-related (MR) cytogenetic-gene-alterations [MR-CG-Gene, as defined in acute myeloid leukemia (AML)-MR (AML-MR)], harboring ALL-genotype, and responded well to ALL-based induction regimens. These findings indicate that B/T MPAL with MR-CG-Gene is more appropriately diagnosed as MPAL rather than AML-MR. Our study is the first to demonstrate immunophenotypic lineage-genotype associations and frequent MR-CG-Gene in B/T MPAL and advocate more studies to refine diagnostic criteria.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152540"},"PeriodicalIF":1.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of SOX6 immunohistochemical expression as a diagnostic marker in the distinction of epithelioid mesothelioma from lung carcinomas","authors":"Fatma Samy Hafez ,&nbsp;Safaa Mahmoud Mohamed Abdelkhalek ,&nbsp;Shaimaa Abdelraouf Elgohary","doi":"10.1016/j.anndiagpath.2025.152553","DOIUrl":"10.1016/j.anndiagpath.2025.152553","url":null,"abstract":"<div><div>Epithelioid mesothelioma (EM) is a pleural malignancy whose many histopathologic patterns may overlap considerably with those of lung adenocarcinoma (LAC) or poorly differentiated squamous cell carcinoma (SCC). This study aimed to evaluate the diagnostic role of SOX6 immunohistochemical expression in EM, study its differential expression in EM, LAC, and SCC, and evaluate the utility of various combinations of SOX6 with established EM markers calretinin and D2–40. The study included 39 EM, 21 LAC, and 11 SCC cases. SOX6 expression was detected in 71.8 % of EM cases. Conversely, all SCC cases were SOX6-negative, and only two LAC cases were SOX6-positive (<em>P</em> &lt; 0.001). The sensitivity and specificity of SOX6 in identifying EM was 71.8 % and 93.8 %, respectively. Calretinin and D2–40 expression was detected in 100 % and 97.4 % cases of EM, respectively. The diagnostic sensitivity of SOX6 for EM in combination with D2–40 and/or calretinin was higher than SOX6 as a solitary marker. Notably, the sensitivity of calretinin and/or SOX6 positive expression was 100 % higher than that of SOX6 combination with D2–40. Although the sensitivity of SOX6 is lower than that of other established markers for EM, it may be a fairly specific marker for the diagnosis of EM. Therefore, the inclusion of SOX6 into an immunohistochemical panel may have diagnostic utility in distinguishing between EM and lung carcinomas. However, more research is needed on a wider array of tumor types from various organs to truly understand its global specificity.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152553"},"PeriodicalIF":1.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological-pathological correlation in encapsulated papillary carcinoma of the breast","authors":"Ying Zhang ,&nbsp;Ya Gao ,&nbsp;Jinrong Wei ,&nbsp;Zhifen Dong","doi":"10.1016/j.anndiagpath.2025.152552","DOIUrl":"10.1016/j.anndiagpath.2025.152552","url":null,"abstract":"<div><div>The study aims to investigate the radiological-pathological correlation in encapsulated papillary carcinoma (EPC) of the breast. We recruited patients with breast EPC between April 2016 and March 2025, and divided them into 3 histologic subtypes: pure EPC, EPC with ductal carcinoma in situ (DCIS), and EPC with invasive carcinoma (IC). Clinical, pathological, mammographic and ultrasonographic manifestations of the three histologic subtypes were analyzed. A total of 48 female patients with EPC were enrolled, with an average onset age of 62.2 ± 12.7 years. Histopathological analysis revealed 25 (52.1 %) pure EPC, 10 (20.8 %) EPC with DCIS, and 13 (27.1 %) EPC with IC. Immunohistochemistry indicated Luminal A predominated in pure EPC and EPC with IC, while Luminal B was more common in EPC with DCIS. The majority of mammography images showed high density or equal density masses with regular shape, and there were no significant differences in the size, morphology, margin, or internal calcification of tumors among the three histologic subtypes (<em>P</em> &gt; 0.05). The majority of ultrasonography images of EPCs showed cystic and solid echogenicity masses with regular morphology and rich blood flow signals. There were no significant differences in the size, echo type, margin, posterior echo enhancement, or blood flow of tumors among the three histologic subtypes of EPC (<em>P</em> &gt; 0.05), but the EPC with IC had a higher proportion of irregular morphology compared with pure EPC (<em>P</em> &lt; 0.05). Therefore, mammography or ultrasonography alone is insufficient to distinguish the histologic subtypes of EPC, but irregular shape on ultrasonography should raise suspicion for non-pure EPC subtypes.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152552"},"PeriodicalIF":1.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-based quantitative assessment of renal chronicity indices in lupus nephritis","authors":"Tianqi TU ,&nbsp;Hui WANG ,&nbsp;Jiangbo PEI ,&nbsp;Xiaojuan YU ,&nbsp;Aidong MEN ,&nbsp;Suxia WANG ,&nbsp;Qingchao CHEN ,&nbsp;Ying TAN ,&nbsp;Feng YU ,&nbsp;Minghui ZHAO","doi":"10.1016/j.anndiagpath.2025.152537","DOIUrl":"10.1016/j.anndiagpath.2025.152537","url":null,"abstract":"<div><div>Renal chronicity indices (CI) have been identified as strong predictors of long-term outcomes in lupus nephritis (LN) patients. However, assessment by pathologists is hindered by challenges such as substantial time requirements, high interobserver variation, and susceptibility to fatigue. This study aims to develop an effective deep learning (DL) pipeline that automates the assessment of CI and provides valuable prognostic insights from a disease-specific perspective.</div><div>We curated a dataset comprising 282 slides obtained from 141 patients across two independent cohorts with a complete 10-years follow-up. Our DL pipeline was developed on 60 slides (22,410 patch images) from 30 patients in the training cohort and evaluated on both an internal testing set (148 slides, 77,605 patch images) and an external testing set (74 slides, 27,522 patch images).</div><div>The study included two cohorts with slight demographic differences, particularly in age and hemoglobin levels. The DL pipeline showed high segmentation performance across tissue compartments and histopathologic lesions, outperforming state-of-the-art methods. The DL pipeline also demonstrated a strong correlation with pathologists in assessing CI, significantly improving interobserver agreement. Additionally, the DL pipeline enhanced prognostic accuracy, particularly in outcome prediction, when combined with clinical parameters and pathologist-assessed CIs.</div><div>The DL pipeline demonstrated accuracy and efficiency in assessing CI in LN, showing promise in improving interobserver agreement among pathologists. It also exhibited significant value in prognostic analysis and enhancing outcome prediction in LN patients, offering a valuable tool for clinical decision-making.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152537"},"PeriodicalIF":1.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyalinizing trabecular tumor of the thyroid: A comprehensive review of clinicopathological features, diagnostic dilemmas, and emerging molecular insights","authors":"Yinghe Huang ,&nbsp;Shanshan Liu ,&nbsp;Yilei Wen","doi":"10.1016/j.anndiagpath.2025.152539","DOIUrl":"10.1016/j.anndiagpath.2025.152539","url":null,"abstract":"<div><div>Hyalinizing trabecular tumor (HTT), a rare thyroid neoplasm, is defined by its unique histopathological architecture and diagnostic complexity due to morphological mimicry of papillary thyroid carcinoma (PTC) and medullary thyroid carcinomas (MTC). This review consolidates contemporary insights into HTT's clinicopathological spectrum, diagnostic ambiguities, and molecular underpinnings. Epidemiologically, HTT predominantly affects middle-aged females, manifesting as circumscribed, asymptomatic nodules. Histologically, trabecular clusters of neoplastic cells embedded within hyalinized stroma are pathognomonic. The nuclear grooves and pseudoinclusions characteristic of HTT overlap with those of PTC, while amyloid-like deposits risk misclassification as MTC, necessitating comprehensive ancillary testing. Definitive diagnosis combines key tests: MIB1 membranous staining. <em>BRAF V600E</em> exclusion for PTC, and calcitonin negativity for MTC exclusion. Emerging molecular evidence reveals recurrent <em>PAX8::GLIS3</em> fusions in &gt;90 % of cases, suggesting diagnostic utility, though their prognostic relevance remains elusive. The most recent WHO classification categorizes HTT as a “low risk neoplasm” owing to the exceptionally low frequency with which it displays lymph node metastases, although debates persist regarding its intrinsic biological behavior. This review underscores the imperative for multidisciplinary collaboration to refine diagnostic accuracy, mitigate overtreatment, and advance targeted therapeutic strategies based on HTT's unique molecular profile.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152539"},"PeriodicalIF":1.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SOX10 and TRPS1 in triple-negative breast cancer: Promise, pitfalls, and the need for broader validation","authors":"Kadri Altundag","doi":"10.1016/j.anndiagpath.2025.152538","DOIUrl":"10.1016/j.anndiagpath.2025.152538","url":null,"abstract":"<div><div>Elgohary et al. reported high TRPS1 and moderate SOX10 expression in triple-negative breast cancer (TNBC). While these findings suggest potential diagnostic value, the absence of non-breast controls, variation in positivity thresholds, and exclusion of small biopsy and neoadjuvant-treated cases limit applicability in metastatic settings. Broader, multi-tumor validation—benchmarked against established marker panels—is needed before routine use in TNBC diagnosis.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152538"},"PeriodicalIF":1.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144851891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do urinary bladder smooth muscle neoplasms show morphologic and immunophenotypic features of their uterine fumarate hydratase-deficient counterparts?","authors":"Haijuan Gao ,&nbsp;Dong Ren ,&nbsp;Giovanna A. Giannico ,&nbsp;Mahmut Akgul ,&nbsp;Francesca Khani ,&nbsp;Laurence A. Galea ,&nbsp;Khaleel I. Al-Obaidy ,&nbsp;Sara M. Falzarano ,&nbsp;Sara E. Wobker ,&nbsp;Keegan Q. Barry-Holson ,&nbsp;Emily Chan ,&nbsp;Austin J. McHenry ,&nbsp;Ankur R. Sangoi","doi":"10.1016/j.anndiagpath.2025.152536","DOIUrl":"10.1016/j.anndiagpath.2025.152536","url":null,"abstract":"<div><div>While the morphologic and immunophenotypic features of smooth muscle neoplasms of the uterus and skin have been well-described in relationship to fumarate hydratase (FH) deficiency (FHD), a potential association of urinary bladder smooth muscle tumors with FH tumor predisposition syndrome (FHTPS) has not been previously investigated. Given an index urinary bladder leiomyoma which showed some of the purported morphologic features seen in uterine FHD leiomyomas, we performed a multi-institutional search for bladder smooth muscle tumors to further evaluate a putative FHTPS association. Cases were re-reviewed for the presence of the following well-described FHD-associated cytomorphologic features: macronucleoli (“cherry red”) surrounded by halo, isolated nuclear pleomorphism (“symplastic” nuclei), cytoplasmic eosinophilic globules, staghorn vasculature, alveolar-pattern edema, and chain-like distribution of smooth muscle fibers. Tumors with available material underwent whole-slide staining for FH and 2SC immunohistochemistry. A total of 40 bladder smooth muscle tumors (35 leiomyomas, 5 leiomyosarcomas) were collected from patients (33 females, 17 males) of ages 30-86 years (mean=56.3 years). Among leiomyomas, cytoplasmic eosinophilic globules were seen most frequently (31%), followed by CMV-like macronucleoli (17%), staghorn-type vasculature (11%), “symplastic” nuclei (9%), and alveolar-pattern edema (6%). Among the leiomyosarcomas, cytoplasmic eosinophilic globules or CMV-like macronucleoli were infrequently seen (20%), while staghorn-type vasculature was seen in 60% and “symplastic” nuclei were seen in all (100%) tumors. No cases exhibited chain-like muscle fibers. Of the stained tumors, all (100%) showed retained FH expression and negative 2SC immunoreactivity. Three female patients with bladder leiomyomas had a prior history of uterine leiomyomas all lacking FHD histology. Although a subset of bladder smooth muscle tumors show overlapping morphologic features with uterine FHD leiomyomas, they do not appear to harbor FHD or an association with FHTPS, although the findings warrant confirmation in future studies, perhaps inclusion of FH and/or 2SC immunohistochemistry.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"79 ","pages":"Article 152536"},"PeriodicalIF":1.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunohistochemistry combined with Alcian Blue-Periodic Acid Schiff (AB-PAS) staining in the differentiation of ovarian seromucinous borderline tumors and mucinous borderline tumors","authors":"Weizhen Lin ,&nbsp;Jintian Gao ,&nbsp;Weibo Hou,&nbsp;Bi Zhong,&nbsp;Dayang Hui,&nbsp;Jiexia Guan","doi":"10.1016/j.anndiagpath.2025.152534","DOIUrl":"10.1016/j.anndiagpath.2025.152534","url":null,"abstract":"<div><div>This study aimed to evaluate the clinicopathological features of ovarian seromucinous borderline tumors (SMBTs) and mucinous borderline tumors (MBTs) and to establish a diagnostic approach using immunohistochemistry (IHC) and Alcian Blue-Periodic Acid Schiff (AB-PAS) histochemical staining. A retrospective analysis of 73 MBT and 34 SMBT cases was conducted at a single institution. Clinical, pathological, IHC (CK7, CK20, ER, PAX8), and histochemical (AB-PAS) features were compared. Both of SMBTs and MBTs frequently occurred in patients under 40 years. Patients with SMBTs were older, their tumors were of significantly smaller tumor size, and were more likely to be bilateral and associated with endometriosis than MBTs. Recurrence rates were 9.1 % (SMBTs) and 1.9 % (MBTs). 85.3 % of SMBTs exhibited CK7 cytoplasmic positive (+++) as compared with 46.6 % of MBTs. All SMBTs were CK20-negative and 68.5 % of MBTs showed CK20 cytoplasmic positivity. 100 % of SMBTs showed ER nuclear positivity, whereas all MBTs were ER-negative. PAX8 were consistently expressed (++/+++) in 97.1 % of SMBTs but 11 % in MBTs, respectively. AB-PAS staining distinguished SMBTs (acidic mucin: blue) from MBTs (neutral mucin: magenta; goblet cells: blue). Overall, our study affirms that SMBTs and MBTs exhibit distinct clinicopathological profiles. A combined IHC panel (CK7, CK20, ER, PAX8) with AB-PAS staining enhances diagnostic accuracy, potentially guiding clinical management.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152534"},"PeriodicalIF":1.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Papillary renal neoplasm with reverse polarity: A distinct entity ready for the World Health Organization classification","authors":"Sean R. Williamson ,&nbsp;Khaleel I. Al-Obaidy","doi":"10.1016/j.anndiagpath.2025.152530","DOIUrl":"10.1016/j.anndiagpath.2025.152530","url":null,"abstract":"","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152530"},"PeriodicalIF":1.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the archives of MD Anderson Cancer Center: Small lymphocytic lymphoma/chronic lymphocytic leukemia diagnosed in Warthin tumor","authors":"Jing Zhou,&nbsp;L. Jeffrey Medeiros","doi":"10.1016/j.anndiagpath.2025.152533","DOIUrl":"10.1016/j.anndiagpath.2025.152533","url":null,"abstract":"<div><div>Warthin tumor is uncommonly associated with lymphoma. We describe a case of a 73-year-old man with persistent left neck swelling in the submandibular region. Core needle biopsy with aspiration showed Warthin tumor and small lymphocytic lymphoma (SLL)/chronic lymphocytic leukemia (CLL). Histologic sections showed fragments of a Warthin tumor composed of oncocytic ductal epithelium in a background of a diffuse infiltration of small lymphocytes with small proliferation centers. The lymphocytes were predominantly CD5-positive monotypic B-cells by immunophenotypic analysis. This is the first report in the literature describing a concurrent Warthin tumor and SLL/CLL diagnosed by needle biopsy with aspiration. Based on our review of the literature and including the current case, 45 cases of lymphoma involving Warthin tumor have been reported previously. Forty-four of these lymphomas were lymph node-based neoplasms, with follicular lymphoma most common (<em>n</em> = 15; 34 %). Five (11 %) cases of SLL/CLL associated with Warthin tumor including the current case have been reported. Notably, extranodal marginal zone lymphoma is rarely associated with Warthin tumor, reported in a single case. These findings support the hypothesis that Warthin tumor arises from heterotopic salivary gland ducts within lymph nodes. We review the pathogenesis of this uncommon phenomenon and discuss the differential diagnosis.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"79 ","pages":"Article 152533"},"PeriodicalIF":1.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}