Breast cancer (Tokyo, Japan)最新文献

{"title":"Pathological homogeneity and utility in the genetic diagnosis of paired mirror samples from breast cancer 10G-vacuum-assisted biopsies using a novel longitudinal dividing device.","authors":"Akira Watanabe, Sae Kitano, Chikage Kato, Ryo Tsunashima, Chise Matsui, Saya Matsumoto, Ikoi Omatsu, Eiichi Konishi, Yoshiaki Sota, Takumi Shiraishi, Masayoshi Okumi, Midori Morita, Koichi Sakaguchi, Osamu Ukimura, Yasuto Naoi","doi":"10.1007/s12282-025-01778-4","DOIUrl":"https://doi.org/10.1007/s12282-025-01778-4","url":null,"abstract":"<p><strong>Background: </strong>The growing need for immunohistochemical and genetic testing often results in shortage of breast cancer vacuum-assisted biopsy (VAB) samples. Their value has become increasingly important with improvements in neoadjuvant chemotherapy outcomes. To enhance diagnostic utility, the longitudinal division of a single VAB sample can provide matched \"mirror samples.\" We adapted a prostate biopsy tissue divider for use with 10G-VAB breast cancer specimens and evaluated its feasibility for pathological and molecular analyses.</p><p><strong>Methods: </strong>A total of 100 10G-VAB specimens from 32 patients were longitudinally bisected using the dividing tool. The pathological concordance between the paired mirror samples was assessed by histological examination. Their suitability for DNA and mRNA analyses was also evaluated by next-generation gene panel sequencing and microarray-based gene expression profiling.</p><p><strong>Results: </strong>Of the 72 samples confirmed to contain malignant tissue, 70 (97.2%) exhibited high pathological concordance between the mirror pairs. The remaining two samples (2.8%), derived from the tumor margins, exhibited discordant histological findings. Moreover, gene panel testing (n = 8) and comprehensive gene expression profiling using microarray (n = 8) were successfully performed on all of the mirror samples (n = 16).</p><p><strong>Conclusion: </strong>The longitudinal division of breast cancer VAB tissue using a specialized dividing device results in anatomically matched mirror samples with high pathological fidelity. These specimens are suitable for advanced molecular diagnostics, thus providing a valuable tool for clinical practice and translational studies.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145153175","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":"Postoperative complications following prepectoral versus subpectoral tissue expander placement in immediate breast reconstruction: a retrospective study from Japan.","authors":"Ryotaro Miyano, Tomohiro Shiraishi","doi":"10.1007/s12282-025-01784-6","DOIUrl":"https://doi.org/10.1007/s12282-025-01784-6","url":null,"abstract":"<p><strong>Background: </strong>Prepectoral implant placement has become a widely adopted alternative to subpectoral reconstruction in implant-based breast surgery, offering reduced postoperative pain and improved aesthetic outcomes. However, in Japan, prepectoral placement of silicone breast implants (SBIs) remains unapproved, and its clinical safety has not been well established.</p><p><strong>Methods: </strong>We conducted a retrospective review of 176 patients (187 breasts) who underwent immediate two-stage breast reconstruction with tissue expander (TE) placement between January 2023 and December 2024. Patients were categorized into prepectoral (128 patients, 135 breasts) and subpectoral (48 patients, 52 breasts) groups. Postoperative complications including infection, seroma, and TE exposure were compared. Univariate and multivariate logistic regression analyses were performed to identify risk factors.</p><p><strong>Results: </strong>Infection occurring without skin or NAC necrosis was more frequent in the prepectoral group (13.3% vs. 2.2%, p = 0.03), with 14 of 17 cases requiring invasive treatment and 10 leading to TE removal or unplanned autologous reconstruction. Seroma occurred in 15.6% of prepectoral cases versus 1.9% of subpectoral (p = 0.01), and TE exposure occurred only in the prepectoral group (4.6%). Multivariate analysis identified prepectoral placement and a final fill ratio < 0.6 as independent predictors of infection. Prepectoral placement was also the sole predictor for seroma.</p><p><strong>Conclusions: </strong>Prepectoral TE placement in Japanese patients was associated with a higher risk of infection, seroma, and TE exposure compared to subpectoral placement. These findings suggest the need for careful patient selection and surgical planning in the context of Japanese clinical practice, where prepectoral SBI use is not yet established.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140001","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":"Impact of breast density on the efficacy of radiofrequency ablation in early-stage breast cancer.","authors":"Manabu Futamura, Yasuko Nagao, Yukiko Takai, Yoshimi Niwa, Akira Nakakami, Mai Okawa, Yoshihisa Tokumaru, Junichi Mase, Ryutaro Mori, Daichi Watanabe, Takayuki Kinoshita, Nobuhisa Matsuhashi","doi":"10.1007/s12282-025-01775-7","DOIUrl":"https://doi.org/10.1007/s12282-025-01775-7","url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency ablation (RFA) is a minimally invasive technique employed in the management of small breast tumors. RFA involves the delivery of a high-frequency current through a needle electrode under ultrasound guidance. In Japan, RFA has been covered by insurance since 2023 as a localized treatment option for early-stage breast cancers.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of patients who underwent RFA at our institution between February 2016 and March 2025. Breast density was classified into four categories based on the Breast Imaging Reporting and Data System. Associations between breast density and RFA parameters, including ablation temperature, time, and impedance, were evaluated.</p><p><strong>Results: </strong>A total of 50 breasts in 49 female patients were treated with RFA. The mean peak ablation temperature recorded after the cooling break was 81.0 ± 8.0 °C. Increased breast density was significantly associated with high temperatures. The mean ablation time until break was 446 ± 139 s, indicating a trend toward prolonged durations in cases involving denser breast tissue. The mean initial and final impedance values were 208 ± 72.3 Ω and 161 ± 66.5 Ω, respectively. Fat-rich breasts exhibited significantly higher impedance values at both time points.</p><p><strong>Conclusion: </strong>Fatty breast tissue is associated with higher impedance, lower peak temperatures, and shorter ablation times, potentially resulting in insufficient ablation. Breast density should be considered when planning RFA to ensure optimal treatment efficacy.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116119","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":"Advances in the intrinsic signaling pathway interactions and clinical translation of HR+/HER2+ breast cancer.","authors":"Xinyu Li, Tao Huang","doi":"10.1007/s12282-025-01779-3","DOIUrl":"https://doi.org/10.1007/s12282-025-01779-3","url":null,"abstract":"<p><p>Hormone receptor-positive (HR +) and HER2-positive (HER2+) breast cancers represent a biologically unique subset of breast malignancies characterized by the co-expression of estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2). These cancers exhibit distinct molecular features, often leading to aggressive growth and higher recurrence rates. HR+/HER2+ breast cancer cells can utilize estrogen and HER2-driven signaling pathways to promote proliferation, survival, and metastatic potential, presenting unique challenges and opportunities for treatment. The current therapeutic strategies focus on a combination of endocrine therapies, such as selective estrogen receptor modulators (e.g., tamoxifen) or aromatase inhibitors, with HER2-targeted therapies like trastuzumab, pertuzumab, or tyrosine kinase inhibitors, to concurrently inhibit both hormone and HER2-driven pathways. Despite initial treatment efficacy, resistance often develops through various mechanisms, including mutations in the PIK3CA gene, cross-talk between ER and HER2 signaling, and activation of alternative growth pathways. Ongoing research aims to improve patient outcomes by exploring novel combination therapies, including CDK4/6 inhibitors and PI3K/AKT/mTOR pathway inhibitors, and by targeting resistance pathways. This review highlights the molecular basis, treatment approaches, and emerging therapeutic strategies in HR+/HER2+ breast cancer, emphasizing the need for personalized and adaptive treatment strategies in managing this complex disease subtype.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126589","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":"A dynamic nomogram predicting persistent breast cancer-related lymphedema: a retrospective cohort study in China.","authors":"Wenting Jiang, Yuanqiang Li","doi":"10.1007/s12282-025-01781-9","DOIUrl":"https://doi.org/10.1007/s12282-025-01781-9","url":null,"abstract":"<p><strong>Background: </strong>Once developed, persistent lymphedema (PLE) is irreversible and imposes multiple adverse challenges and a heavy economic burden on patients and the healthcare industry. This study aims to develop a risk nomogram model for PLE in breast cancer-related lymphedema (BCRL) patients and visualize it as a free online prediction website to guide individualized risk stratification and graded management.</p><p><strong>Methods: </strong>418 BCRL patients who underwent axillary lymph node dissection (ALND) among 2176 postoperative breast cancer patients from January 2020 to December 2022 were retrospectively enrolled as research subjects. Univariate and logistic regression models were performed to identify risk factors. A visual dynamic nomogram was constructed using R and Shinyapps software, followed by validation of its discrimination, calibration, and clinical validity.</p><p><strong>Results: </strong>PLE incidence was 32.78%. Age, ALND level, severity of lymphedema, dominant side, and lymph node metastasis were significant risk factors for PLE (P < 0.05). The nomogram's C index was 0.827 (95%CI 0.774-0.880) in the training cohort and 0.849 (95%CI 0.782-0.916) in the validation cohort. Calibration curves showed good consistency across both cohorts. Decision curve analysis confirmed the good clinical validity, identifying 36% as the optimal threshold probability.</p><p><strong>Conclusion: </strong>The dynamic nomogram, leveraging readily available clinical parameters, offers a clinically applicable web-based platform for dynamic risk quantification of PLE, facilitating early prediction, resource allocation, and prognosis management for high-risk PLE patients.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126621","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":"Acknowledgments to reviewers 2025.","authors":"","doi":"10.1007/s12282-025-01776-6","DOIUrl":"https://doi.org/10.1007/s12282-025-01776-6","url":null,"abstract":"","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088777","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":"Prevalence of germline CHEK2 variants in East Asians and Koreans based on population genomic databases.","authors":"Jong Eun Park, Taeheon Lee, Eun Hye Cho, Mi-Ae Jang, Dongju Won, Boyoung Park, Jung-Sook Ha, Do Hoon Kim, Kyoung-Bo Kim, Chang-Seok Ki, Sun-Young Kong","doi":"10.1007/s12282-025-01774-8","DOIUrl":"https://doi.org/10.1007/s12282-025-01774-8","url":null,"abstract":"<p><p>Checkpoint kinase 2 (CHEK2) encodes a serine/threonine kinase involved in the DNA damage response through ATM-Chk2-p53 signaling. Its function in maintaining genomic stability classifies it as a tumor suppressor. Heterozygous germline pathogenic variants in CHEK2 are associated with a moderate increase in lifetime risk of breast and prostate cancer. This study assessed the prevalence of CHEK2 variants globally, with a focus on East Asian and Korean populations, for which data have remained limited. We analyzed 125,748 exomes from the Genome Aggregation Database (gnomAD), including 9,197 East Asians, along with additional data from 5,305 individuals in the Korean Variant Archive, 3,617 in Korea4K, and 1,722 in the Korean Reference Genome Database. All CHEK2 variants were classified according to guidelines established by the American College of Medical Genetics, Genomics, and Clinical Genome Resources. The global prevalence of CHEK2 variants was 0.76%, with the highest observed in the Finnish population (2.04%) and the lowest in East Asians (0.11%). By integrating data from Korean genomic databases and gnomAD, representing a total of 12,553 Korean individuals, the overall prevalence in the Korean population was estimated at 0.13%. These findings represent the first integrated estimate of CHEK2 variant frequency in Koreans using multiple population-specific genomic datasets. The results provide a useful reference for future studies and highlight the need for region-specific genetic research to inform counseling and hereditary cancer risk management.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071528","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":"C-type lectin-like domain family 2 (CLEC2D) promotes proliferation and migration of breast cancer and serves as a poor prognostic factor.","authors":"Mio Yamaguchi-Tanaka, Yui Kurihara, Kiyoshi Takagi, Ai Sato, Iori Yasuda, Yuto Yamazaki, Minoru Miyashita, Takashi Suzuki","doi":"10.1007/s12282-025-01777-5","DOIUrl":"https://doi.org/10.1007/s12282-025-01777-5","url":null,"abstract":"<p><strong>Background: </strong>C-type lectin-like domain family 2 (CLEC2D), a transmembrane protein, is a ligand for the inhibitory receptor CD161, which is expressed in several types of immune cells. CLEC2D expressed on cancer cells suppresses antitumor effect of these cells by interacting with CD161 in human malignancies. However, its clinical significance in breast cancer and its direct biological role in cancer cells remain largely unclear.</p><p><strong>Methods: </strong>In this study, we immunolocalized CLEC2D in 174 breast cancer tissues and correlated its immunoreactivity with clinicopathological parameters and clinical outcomes. Additionally, we conducted in vitro assays to examine the effects of CLEC2D on the proliferation and migration of breast cancer cell lines.</p><p><strong>Results: </strong>CLEC2D immunoreactivity was predominantly detected in the cytoplasm of breast cancer cells and was associated with increased proliferation and invasion, as well as poor clinical outcomes especially in those who had received chemotherapy. In vitro experiments demonstrated that the knockdown of CLEC2D significantly suppressed the proliferation and migration of MCF-7, MDA-MB-231, T-47D breast cancer cells.</p><p><strong>Conclusion: </strong>We therefore concluded that CLED2D directly promoted breast cancer cell proliferation and migration independently of immune cells and served as a poor prognostic factor in breast cancer.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042714","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":"Deep learning mammography-based breast cancer risk model, its serial change, and breast cancer mortality.","authors":"Sujeong Shin, Yoosoo Chang, Seungho Ryu","doi":"10.1007/s12282-025-01772-w","DOIUrl":"https://doi.org/10.1007/s12282-025-01772-w","url":null,"abstract":"<p><strong>Background: </strong>Although numerous breast cancer risk prediction models have been developed to categorize individuals by risk, a substantial gap persists in evaluating how well these models predict actual mortality outcomes. This study aimed to investigate the association between Mirai, a deep learning model for risk prediction based on mammography, and breast cancer-specific mortality in a large cohort of Korean women.</p><p><strong>Methods: </strong>This retrospective cohort study examined 124,653 cancer-free women aged ≥ 34 years who underwent mammography screening between 2009-2020. Participants were stratified into tertiles by Mirai risk scores and categorized into four groups based on risk changes over time. Cox proportional hazards regression models were used to evaluate the associations of both baseline Mirai scores and temporal risk changes with breast cancer-specific mortality.</p><p><strong>Results: </strong>Over 1,075,177 person-years of follow-up, 31 breast cancer-related deaths occurred. The highest Mirai risk tertile showed significantly higher breast cancer-specific mortality than the lowest tertile (hazard ratio [HR], 5.34; 95% confidence interval [CI] 1.17-24.39; p for trend = 0.020). Temporal Mirai score changes were associated with mortality risk: those remaining in the high-risk (HR, 5.92; 95% CI 1.43-24.49) or moving from low to high risk (HR, 5.57; 95% CI 1.31-23.63) had higher mortality rates than those staying in low-risk.</p><p><strong>Conclusions: </strong>The Mirai model, developed to predict breast cancer incidence, was significantly associated with breast cancer-specific mortality. Changes in Mirai risk scores over time were also linked to breast cancer-specific mortality, supporting AI-based risk models in guiding risk-stratified screening and prevention of breast cancer-related deaths.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986100","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":"Macroscopic morphology of breast carcinoma: associations with biological subtypes and pathological features.","authors":"Yuki Hara, Rin Yamaguchi, Ryota Otsubo, Shintaro Urakawa, Aya Tanaka, Momoko Akashi, Sayaka Kuba, Megumi Matsumoto, Susumu Eguchi, Keitaro Matsumoto","doi":"10.1007/s12282-025-01770-y","DOIUrl":"https://doi.org/10.1007/s12282-025-01770-y","url":null,"abstract":"<p><strong>Background: </strong>Morphological features of tumors can reflect the biological behavior of breast carcinoma; however, a consensus macroscopic classification remains elusive. In this study, we aimed to elucidate the relationship between macroscopic morphology and biological behavior of breast carcinoma.</p><p><strong>Methods: </strong>We evaluated 328 post-operative breast carcinomas, stratifying them by hormone receptor/human epidermal growth factor receptor 2 (HER2) status (luminal-like, luminal-HER2, HER2-positive [non-luminal], triple-negative), and morphological patterns. The tumors comprised infiltrative (n = 101), expansive (n = 93), non-mass (n = 62), mixed (n = 59), and unclassifiable (n = 13). Expansive and non-mass types were sub-classified as acellular, rich vessel, cystic, glossy, comedo, or ductal. Furthermore, we assessed histopathological features, including linear fibrosis, central scar, central cavity, spot necrosis, comedo necrosis, intraductal secretion, and blood spots.</p><p><strong>Results: </strong>Infiltrative tumors were primarily luminal-like with a central scar (57/101, 56%) and linear fibrosis (98/101, 97%); expansive tumors were frequently triple-negative with spot necrosis (21/93, 23%), and blood spots (33/93, 35%); non-mass tumors were usually HER2-positive (non-luminal) with comedo necrosis (27/62, 44%) and intraductal secretion (42/62, 68%). In histological diagnosis, infiltrative types were commonly invasive breast carcinoma of no special type (54/101, 53%); expansive types included invasive solid papillary carcinoma (iSPC) (21/93, 23%); and non-mass types encompassed ductal carcinoma in situ (DCIS) (28/62, 45%). Rich vessel lesions aligned with iSPC, acellular with squamous cell carcinoma, cystic with encapsulated papillary carcinoma, glossy with mucinous carcinoma, and comedo with high-grade DCIS.</p><p><strong>Conclusion: </strong>Our findings demonstrated that morphological classification of breast carcinoma correlates with biological features and may aid diagnostic strategies, including imaging and pathological subtype diagnosis.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986059","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}