American journal of clinical pathology最新文献

{"title":"Confirmation of the donor origin of de novo hepatocellular carcinoma after liver transplant using microsatellite analysis.","authors":"Wei Zhang, Jane Houldsworth, Thomas D Schiano, M Isabel Fiel","doi":"10.1093/ajcp/aqaf078","DOIUrl":"10.1093/ajcp/aqaf078","url":null,"abstract":"<p><strong>Objective: </strong>The recurrence of hepatocellular carcinoma (HCC) after liver transplant (LT) occurs in 10% to 15% of cases, but de novo HCC arising in an allograft is a rare occurrence. The aim of this study was to determine the origin of post-LT de novo HCC as either donor or recipient by using molecular analysis.</p><p><strong>Methods: </strong>Using the LT database (2000-2019), a search was performed for patients who developed de novo HCC and underwent a second LT. Archival formalin-fixed, paraffin-embedded blocks were retrieved. Fragment analysis of 16 polymorphic short tandem repeat (STR) loci was performed on the de novo tumor, background allograft liver, and a recipient control tissue. The origin of the de novo HCC was determined by comparing the informative STR-polymerase chain reaction products from the 3 different specimen sources.</p><p><strong>Results: </strong>Histologically, the HCC showed well to moderately differentiated morphology. Obliterative portal venopathy (OPV) was seen in all 4 cases, and 2 cases showed nodular regenerative hyperplasia (NRH); cirrhosis was absent in all cases. All HCCs were of donor origin.</p><p><strong>Conclusions: </strong>Our study shows that in this cohort, all de novo HCCs were of donor origin, and OPV/NRH was a common concurrent finding. Short tandem repeat analysis is helpful in differentiating whether HCC in the appropriate post-LT clinical setting is of donor origin.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"492-499"},"PeriodicalIF":1.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688599","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":"Collagenase type IV improves the quality of HER2 fluorescence in situ hybridization for breast cancers.","authors":"Shang-En Lee, Sheng-Chi Hsu, Tsai-Hsien Hung, Kwai-Fong Ng, Tse-Ching Chen","doi":"10.1093/ajcp/aqaf049","DOIUrl":"10.1093/ajcp/aqaf049","url":null,"abstract":"<p><strong>Objective: </strong>Autofluorescence often hampers the interpretation of fluorescence in situ hybridization (FISH). This study aimed to develop a novel pretreatment method to reduce autofluorescence and improve HER2 FISH quality for breast cancer diagnosis.</p><p><strong>Methods: </strong>Autofluorescence, predominantly originating from the extracellular matrix, was targeted for reduction using enzymatic pretreatment. Formalin-fixed, paraffin-embedded breast cancer sections (4 µm thick) were treated with extracellular matrix enzymes, including type I collagenase, type IV collagenase, and elastase, before standard HER2 FISH. A total of 112 breast cancer samples were assessed for autofluorescence reduction and FISH signal clarity.</p><p><strong>Results: </strong>Type IV collagenase proved most effective in reducing autofluorescence. With standard FISH, 25 (22.3%) of 112 samples exhibited strong autofluorescence, obscuring probe signals. Following type IV collagenase pretreatment, previously indiscernible signals became evaluable. Among these, 1 sample initially difficult to classify was reclassified as HER2 positive based on the HER2/CEP17 ratio and HER2 copy number.</p><p><strong>Conclusions: </strong>In this study, we demonstrated type IV collagenase pretreatment could effectively reduce the extracellular matrix autofluorescence and improve the resolution of probe signals. Therefore, this pretreatment method could enhance the accuracy of the HER2 FISH results.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"342-350"},"PeriodicalIF":1.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504475","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":"Exploring the performance of an artificial intelligence- and morphology-driven workflow integrating 4 platelet enumeration technologies.","authors":"Julien Guy, Marie-C Béné, Ramon Simon Lopez, Marc Maynadié, Céline Row","doi":"10.1093/ajcp/aqaf055","DOIUrl":"10.1093/ajcp/aqaf055","url":null,"abstract":"<p><strong>Objective: </strong>Platelet count, one of the main parameters of the complete blood count, requires accurate evaluation to guide patient management. It can be hampered by EDTA-induced pseudo-thrombocytopenia (PTCP), microcytic red blood cells (RBCs), RBC fragments, or giant platelets. A new set of 4 methods from the Mindray CAL-8000 platform, applicable on a single sample for platelet count, was evaluated.</p><p><strong>Methods: </strong>The 4 options of the platform respectively use impedance (PLT-I); optical assessment (PLT-O) with a disaggregating agent; morphology (PLT-M) assessed by artificial intelligence-aided visualization on a smear prepared, stained, and analyzed by the platform; and PLT-Pro with morphologic assessment on a larger area of the smear. As part of an evaluation of the Mindray solution, a total of 2474 samples, collected on EDTA and sent for routine CBC, were further evaluated on the CAL-8000. The methods were combined according to a predefined algorithm.</p><p><strong>Results: </strong>An automated report with accurate evaluation was ultimately obtained for 100% of the samples, using the sequence PLT-I, PLT-O, PLT-M, and PLT-Pro, which allowed accurate counting even in the presence of PTCP-related clumps.</p><p><strong>Conclusions: </strong>Although this was a proof-of-concept assay including all analysis parameters, it validated the proposed new algorithm that can be implemented for routine flags.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"385-389"},"PeriodicalIF":1.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265074","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":"Vascular outflow obstruction changes and low prevalence of advanced fibrosis characterize the liver pathology in orthotopic heart transplant recipients.","authors":"Bethany Freeland LeClair, John Yablonski, Wei Chen, Chanjuan Shi, Kara Wegermann, Avani A Pendse","doi":"10.1093/ajcp/aqaf092","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf092","url":null,"abstract":"<p><strong>Objective: </strong>The number of orthotopic heart transplants (OHTs) performed each year continues to increase, as does the post-transplant survival rate. Little is known, however, about the morphologic changes in the liver after the patient has undergone an OHT. In this study, we retrospectively reviewed liver pathology in patients following OHT to comprehensively describe the histopathologic changes, particularly fibrosis.</p><p><strong>Methods: </strong>Three pathologists retrospectively reviewed liver biopsy samples in patients who had undergone OHT using a standardized checklist format.</p><p><strong>Results: </strong>In our cohort of 19 biopsies, the morphologic features of hepatic injury noted were in the form of vascular outflow obstruction (9 biopsies), portal inflammation (13 biopsies), cholestasis (8 biopsies), and steatosis/steatohepatitis (5 biopsies). There was no evidence of nodular regenerative hyperplasia. Five of 9 patients with vascular outflow obstruction had sinusoidal fibrosis. Of 8 patients with clinical suspicion of portal hypertension and cirrhosis, only 3 demonstrated advanced fibrosis.</p><p><strong>Conclusions: </strong>This is the first comprehensive account of histopathologic changes in the liver following OHT. This information will be beneficial for clinical decision-making when monitoring hepatic function and fibrosis in patients with OHT.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938799","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":"History matters: Preventing severe allergic transfusion reactions.","authors":"Edina A Wappler-Guzzetta, Asad Shafiq, Umaima Asad, Tushar Chakravarty, Elena G Nedelcu","doi":"10.1093/ajcp/aqaf093","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf093","url":null,"abstract":"<p><strong>Objective: </strong>Prior studies have shown that pretransfusion medication is not effective in preventing allergic transfusion reactions (ATRs), but these studies did not consider the patient's history of ATR. This study evaluated whether pretransfusion antiallergy medications decrease the chance of ATRs in patients with a history of severe ATR.</p><p><strong>Methods: </strong>This single-center, retrospective study investigated the effect of pretransfusion medications on preventing ATRs in patients with a history of at least 1 severe ATR between March 2018 and January 2024. Patient demographics as well as clinical and transfusion reaction data were collected from our electronic health record (EHR) system. Data were analyzed using SPSS (IBM Corp) and machine learning in Python, version 3.12.4.</p><p><strong>Results: </strong>In our cohort, 53 patients aged 5 weeks to 94 years with 2767 analyzable transfusion encounters had experienced 88 lifelong mild and severe ATRs. Premedication (P = .021), regular antiallergy medication (P < .001), and washing/volume reduction (P = .032) were associated with a statistically significantly lower chance of developing ATRs in our patient population.</p><p><strong>Conclusions: </strong>Patients with at least 1 severe ATR benefit from pretransfusion administration of antiallergy medications.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938881","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 turnaround times and performance of in-house ChromaCode high-definition PCR compared to send-out next-generation sequencing in non-small cell lung cancer.","authors":"Nathan C Hogarth, Mustafa Al-Kawaaz, Mark W Linder","doi":"10.1093/ajcp/aqaf038","DOIUrl":"10.1093/ajcp/aqaf038","url":null,"abstract":"<p><strong>Objective: </strong>Lung cancer is the leading cause of cancer deaths globally, with 1.8 million deaths annually. Advances in targeted therapy and molecular testing for key mutations in non-small cell lung cancer (NSCLC) have improved survival rates. The benchmark turnaround time for molecular testing is 10 days; however, send-out next-generation sequencing (NGS) can often take 14 to 28 days.</p><p><strong>Methods: </strong>The ChromaCode NSCLC assay uses a novel \"high-definition polymerase chain reaction (PCR)\" technology on digital PCR instruments to detect mutations in 9 genes derived from the most current guidelines provided by the National Comprehensive Cancer Network, as well as separate testing guidelines as a collaborative effort by the College of American Pathologists, the International Association for the Study of Lung Cancer, and the Association for Molecular Pathology. This includes testing for mutations in EGFR, BRAF, KRAS (G12C only), MET and RNA fusions in RET, ROS1, ALK, and NTRK1/2/3. This study retrospectively assessed the feasibility of implementing the assay in a medium-sized academic institution, with a detailed workflow analysis using 58 paraffin-embedded tissue specimens diagnosed as NSCLC.</p><p><strong>Results: </strong>Of the 58 samples, 100% concordance was observed between NGS and ChromaCode assays, with all 5 (~8.6%) positive cases-including 1 ROS1, 1 EGFR L858R, 1 KRAS G12C, and 2 NTRK1/2/3 rearrangements-accurately detected. Implementation of the ChromaCode NSCLC assay allows for an average institution-specific turnaround time of 5.01 days, subject to logistical constraints, compared to 10.4 days for send-out next-generation sequencing (U statistic = 153; α = 0.05).</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"226-232"},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951979","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":"Optimizing electronic health records: Integration of human factors engineering for enhanced pathology report display and accessibility.","authors":"Ethan P Larsen, Mohammad Jalloul, Moira P Larsen","doi":"10.1093/ajcp/aqaf024","DOIUrl":"10.1093/ajcp/aqaf024","url":null,"abstract":"<p><strong>Objective: </strong>The integration of human factors engineering (HFE) into electronic health records (EHRs) is essential to enhance the display and accessibility of pathology reports. Pathology testing is central to clinical decision-making, yet the current EHR interfaces present challenges in test ordering and result interpretation, contributing to diagnostic errors. This study explores the application of HFE principles to redesign EHR visual displays, specifically for HIV and urine toxicology testing.</p><p><strong>Methods: </strong>By involving pathologists and clinicians in the design process, we developed user-centric templates that improve result clarity and accessibility. We also describe case examples of one successful template prototype implementation and one where technical barriers highlight limitations of applying user-centered design within the constraints of EHR and Laboratory Information System applications. The redesigned reports emphasize critical information through standardized color codes and organized data presentation, making nonstandard findings more prominent.</p><p><strong>Discussion: </strong>These interventions have the potential to create improved clinician comprehension and workflow efficiency, ultimately supporting better patient care. The study highlights the importance of incorporating HFE principles into EHR design and advocates for broader adoption to enhance usability and safety in health care settings.</p><p><strong>Conclusions: </strong>Further collaboration with regulatory bodies could establish standardized guidelines, fostering more effective EHR systems across the industry.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"174-181"},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172360","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":"Pediatric thyroid nodules: A comprehensive study of cytology, histology, molecular findings, and risk of malignancy with emphasis on atypia of undetermined significance category.","authors":"Sandra Ixchel Sanchez, Shirin Abbasi, Mahalia T Robinson, Zahra Maleki","doi":"10.1093/ajcp/aqaf034","DOIUrl":"10.1093/ajcp/aqaf034","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric thyroid nodules are more challenging in clinical practice than in adults. Herein, we report our comprehensive experience with pediatric thyroid nodules, including cytology, histology, and molecular correlation.</p><p><strong>Methods: </strong>Pediatric thyroid fine needle aspiration (FNA) performed from 2014 to 2024 was identified. Patients' demographics, FNA site, number and size of nodules, Bethesda category diagnosis, molecular studies, and surgical diagnoses were recorded.</p><p><strong>Results: </strong>In 310 reports, 378 nodules from 302 patients were included. Patients' mean age was 17.0 years (range, 1-21 years). Applying the Bethesda system, benign diagnoses were most common (198/378, 52.4%), while the indeterminate category of atypia of undetermined significance (AUS) was the most prevalent (51/378, 13.5%). Surgical resection was performed in 36.8% (139/378) of cases, revealing malignancy in 50.0% of AUS, 45.4% of follicular neoplasms, and 93.8% of suspicious-for-malignancy cases. Among AUS subtypes, nuclear atypia was most frequently noted (16/30, 53.3%) and linked to papillary thyroid carcinoma in half of these cases (8/16, 50.0%). The risk of malignancy (ROM) increased with age and showed a female predominance (81.9%), with 86.1% of malignancies in the 16- to 21-year age group and no malignant histology in ages 0 to 5 years. Molecular testing, including Afirma (34/38, 89.5%) and Thyroseq (4/38, 10.5%), often returned suspicious (16/34, 47.1%) or intermediate (3/4, 75.0%) results.</p><p><strong>Conclusions: </strong>Indeterminate diagnoses in pediatrics posed a significant ROM, particularly in female adolescents and early adulthood (ages 16-21 years). The AUS category was the most common among indeterminate categories, with AUS nuclear highly associated with malignancy. No malignancy was seen in ages 0 to 5 years.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"207-215"},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965580","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":"KRAS may facilitate transformation of chronic lymphocytic leukemia to histiocytic sarcoma with indeterminate dendritic cell features.","authors":"Farhan Hassan, Hailing Zhang, Dietrich Werner Idiaquez, Nagehan Pakasticali, Elizabeth Hyjek, Mohammad Hussaini","doi":"10.1093/ajcp/aqaf041","DOIUrl":"10.1093/ajcp/aqaf041","url":null,"abstract":"<p><strong>Objective: </strong>We sought to investigate the molecular mechanism underlying transformation of chronic lymphocytic leukemia (CLL) to histiocytic sarcoma (HS) with indeterminate dendritic cell (IDC) features.</p><p><strong>Methods: </strong>Extensive NGS-based genomic profiling was performed on samples of a patient who had CLL, secondary HS with IDC features, and CMML. Clonotypic evaluation of VDJ rearrangement status was performed to confirm clonal relatedness.</p><p><strong>Results: </strong>HS is a rare proliferation of malignant tissue histiocytes that is usually primary, although secondary HS exists and often demonstrates mutations in the Ras/Raf/MAPK or PI3K/AKT/mTOR pathways, but HS with indeterminate dendritic cell (IDC) features has not been previously reported. A 77-year-old man with chronic lymphocytic leukemia (CLL) presented with an oropharyngeal mass. Biopsy specimen showed large atypical histiocytic cells with oval-to-irregular indented nuclei. They were positive for CD33, CD4, CD68 (subset, weak), CD163 (subset, weak), BCL6, S100 (subset), CD1a, cyclin D1 (subset), and lysozyme (weak) but negative for Langerin, BRAF V600E, CD21, CD23, CD35, CD123, TCF4, TCL1, MPO, CD20, CD79a, CD10, MUM1, and BCL2. The patient was diagnosed with secondary HS with IDC features as well as chronic myelomonocytic leukemia (CMML) in the bone marrow. Careful genomic dissection of all 3 types of malignant cells showed that SF3B1 p.E622D was present in both CLL and HS but not CMML. In addition, the HS acquired KRAS p.G13D, which we hypothesize drove the transdifferentiation of CLL to HS. Moreover, next-generation sequencing (NGS) clonotypic evaluation of variable-diversity-joining (VDJ) rearrangements in both the HS and CLL established relatedness but not the CMML.Conclusion: This is the first report of secondary HS with IDC features arising from CLL. We establish by both IGH NGS analysis and mutational profiling that the CLL and HS are clonally-related and posit that acquisition of KRAS p.G13D drove transdifferentiation. This has therapeutic implications for targeting the RAS-BRAF-MAPK-ERK pathway.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"157-162"},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148762","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":"A critical analysis of CellaVision systems in the modern hematology laboratory.","authors":"Brydon Panozzo, Jaineel Ramnarain, Song Chen, Hiu Lam Agnes Yuen, Maciej Tatarczuch, Shahla Vilcassim, Christopher Chang-Yew Leow, Chris Barnes","doi":"10.1093/ajcp/aqaf045","DOIUrl":"10.1093/ajcp/aqaf045","url":null,"abstract":"<p><strong>Objective: </strong>This review aims to provide a comprehensive analysis of the current literature regarding the use of CellaVision digital morphology systems and to assess the emerging applications, their potential to supplement current diagnostic pathways, and-importantly-appreciate their practical and perceived limitations.</p><p><strong>Methods: </strong>A manual literature review was conducted to identify relevant journal articles and published abstracts as they relate to the application of CellaVision systems to hematology laboratory practice in human patients.</p><p><strong>Results: </strong>CellaVision systems can characterize cellular morphology with overall a high degree of accuracy-in particular, for neutrophils; lymphocytes; and common red blood cell changes, including target cells. Challenges remain, however, with the detection of particular important findings, including immature granulocytes and red blood cell agglutination. The application of CellaVision systems to emerging areas such as telepathology and parasitology are evolving, with an increasing volume of literature highlighting the technology's utility.</p><p><strong>Conclusion: </strong>CellaVision systems and associated digital technologies are poised to play an increasingly important role in hematology laboratories, with promises of enhanced accuracy and improved workflows. Several critical deficiencies highlight the necessity for continued research to support their transition into routine clinical practice.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"163-173"},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}