Breast Care最新文献

{"title":"Primary Prevention and Early Detection of Hereditary Breast Cancer.","authors":"Dorothee Speiser, Ulrich Bick","doi":"10.1159/000533391","DOIUrl":"10.1159/000533391","url":null,"abstract":"<p><strong>Background: </strong>Primary prevention and early detection of hereditary breast cancer has been one of the main topics of breast cancer research in recent decades. The knowledge of risk factors for breast cancer has been increasing continuously just like the recommendations for risk management. Pathogenic germline variants (mutations, class 4/5) of risk genes are significant susceptibility factors in healthy individuals. At the same time, germline mutations serve as biomarkers for targeted therapy in breast cancer treatment. Therefore, management of healthy mutation carriers to enable primary prevention is in the focus as much as the consideration of pathogenic germline variants for therapeutic decisions. Since 1996, the German Consortium has provided quality-assured care for counselees and patients with familial burden of breast and ovarian cancer.</p><p><strong>Summary: </strong>Currently, there are 23 university centers with over 100 cooperating DKG-certified breast and gynecological cancer centers. These centers provide standardized, evidence-based, and knowledge-generating care, which includes aspects of primary as well as secondary and tertiary prevention. An important aspect of quality assurance and development was the inclusion of the HBOC centers in the certification system of the German Cancer Society (GCS). Since 2020, the centers have been regularly audited and their quality standards continuously reviewed according to quality indicators adapted to the current state of research. The standard of care at GC-HBOC' centers involves the evaluation as well as evolution of various aspects of care like inclusion criteria, identification of new risk genes, management of variants of unknown significance (class 3), evaluation of risk-reducing options, intensified surveillance, and communication of risks. Among these, the possibility of intensified surveillance in the GC-HBOC for early detection of breast cancer is an important component of individual risk management for many counselees. As has been shown in recent years, in carriers of pathogenic variants in high-risk genes, this approach enables the detection of breast cancer at very early, more favorable stages although no reduction of mortality has been demonstrated yet. The key component of the intensified surveillance is annual contrast-enhanced breast MRI, supplemented by up to biannual breast ultrasound and mammography usually starting at age 40.</p><p><strong>Key messages: </strong>Apart from early detection, the central goal of care is the prevention of cancer. By utilizing individualized risk calculation, the optimal timeframe for risk-reducing surgery can be estimated, and counselees can be supported in reaching preference-sensitive decisions.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10730103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47158809","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}

{"title":"Contents Vol. 18, 2023","authors":"MD – Rupert Bartsch, MD – Ute Berndt, MD – Massimo Calabrese, MD – Stefanie Corradini, MD Peter Dall, MD – BrustGesundheitZentrum Daniel Egle, Tirol, PhD – Martin Filipits, MD – Breast Oreste Davide Gentilini, Surgery, MD – Gynecological Volker Hanf, Kerstin Hermelink, PhD – Breast Center, MD – Jens Huober, MD – Thorsten Kühn, MD – Annette Lebeau, MD – Christian Marth, MD – Volker Möbus, MD – Volkmar Müller, MD – Markus Müller-Schimpfle, MD PhD – Mafalda Oliveira, MD – Georg Pfeiler, MD – Toralf Reimer, MD – Alexandra Resch, MD – Marcus Schmidt, MD – Walter Paul Weber, MD – Joachim Widder, MD – Isabell Witzel, MD – Rachel Würstlein, Munich Sylvia Heywang-Köbrunner, Raimund Jakesz, C. Suppan, M. Balic, Graz, Erratum, PharmaNews No, L. Kiesel, M. Sourouni, M. Khosla, R. Vidya, Wolverhampton Kothari, A. London, B. M. Gulluoglu","doi":"10.1159/000535581","DOIUrl":"https://doi.org/10.1159/000535581","url":null,"abstract":"","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139015680","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":"Intention to Undergo Clinical Breast Examination and Its Associated Factors among Women Attending Rural Primary Healthcare Facilities in South Central Ethiopia.","authors":"Bezawit Ketema, Mirgissa Kaba, Sarah Negash, Adamu Addissie, Eva Johanna Kantelhardt","doi":"10.1159/000531944","DOIUrl":"10.1159/000531944","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is a global public health problem with higher mortality in developing countries. The Ethiopian National Cancer Control Plan recommends clinical breast examination (CBE) for all women aged >18 years. However, there is low breast examination practice in Ethiopia. Therefore, this study aimed to describe level of intention to undergo CBE and associated factors among women visited selected rural healthcare facilities in south central Ethiopia using Theory of Planned Behavior (TPB).</p><p><strong>Methods: </strong>This study used facility-based cross-sectional study design. A total of 420 women participated in this study. Interviewer-administered structured questionnaire was adopted from previously published research works and Ajzen's TPB manual. Statistical Package for Social Sciences (SPSS), version 27, was used for analysis. Binary logistic regression model was used to determine factors associated with intention to undergo CBE.</p><p><strong>Results: </strong>In this study, nine out of ten women had never had CBE. Mean score for intention to undergo CBE was 12.55 (SD ± 3.22; min 5, max 20). Intention to undergo CBE was negatively associated with being in the second and middle wealth quantiles compared to the highest wealth quantile, and with the spouse not being able to read or write compared to having attended formal education. Positive attitude and higher subjective norm had relevant association with intention to undergo CBE.</p><p><strong>Conclusion: </strong>The high score for intention to undergo CBE should encourage primary healthcare facilities to offer CBE. Behavioral change communication interventions could address women's attitude, subjective norm, and spouse's education associated with intention to undergo CBE.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10730096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43542125","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}

{"title":"Which Patients Need Chemotherapy? From Pathological Risk Factors to Gene Signatures and Evaluation of Endocrine Response.","authors":"Marcus Schmidt","doi":"10.1159/000530818","DOIUrl":"10.1159/000530818","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy, used either before or after surgery, has significantly improved survival in early breast cancer. Accurate risk assessment is essential to avoid both overtreatment and undertreatment. This review provides an overview of the evolution of chemotherapy as well as risk factors for tailored systemic therapies in early breast cancer - from pathologic risk factors to gene expression signatures to endocrine response assessment.</p><p><strong>Summary: </strong>Chemotherapy has improved dramatically in recent decades from its beginnings with conventionally dosed cyclophosphamide plus methotexate plus 5-fluorouracil to dose-dense anthracycline- and taxane-containing regimens. Similarly, risk assessment has evolved starting from traditional pathologic risk factors such as tumor size, axillary nodal status, and grading. In recent decades, gene expression signatures have improved prognostic accuracy with a high level of evidence. In turn, these signatures can be further improved by incorporating the aforementioned pathologic factors. As an important step away from this static assessment, dynamic assessment of proliferation factor Ki-67 after short-term preoperative endocrine treatment has gained interest to improve risk assessment in early hormone receptor-positive breast cancer.</p><p><strong>Key message: </strong>This review highlights advances in chemotherapy and risk assessment in early breast cancer, from pathologic risk factors for recurrence to gene expression signatures and endocrine response assessment. These developments are leading to better risk stratification and thus better adaptation of therapies.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10730099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42490344","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}

{"title":"The factors influencing shoulder mobility disorders in patients after radical breast cancer surgery","authors":"Xin Zhang, Chao Wang, Jiali Fan, Shinichiro Murakami, Hualong Xie, Ming Huo","doi":"10.1159/000535063","DOIUrl":"https://doi.org/10.1159/000535063","url":null,"abstract":"Abstract Introduction: To investigate the factors influencing shoulder mobility in terms of pain, grip strength, and supraspinatus muscle thickness in patients with impaired shoulder mobility during radiotherapy after radical breast cancer surgery. Methods: This study included 165 female patients with unilateral breast cancer who had shoulder joint mobility disorders during chemotherapy within 3 months after surgery. The clinical examination included the maximum active range of motion of the shoulder (flexion, extension, abduction, adduction, external rotation, and internal rotation), pain score (visual analog scale [VAS]), grip strength, and supraspinatus muscle thickness. Results: During shoulder abduction, supraspinatus muscle thickness was greatest at 90°, lowest at 0°, and higher at 60° than at 30° (p<0.01). The factors influencing the active movement of shoulder flexion were the VAS score, body weight, grip strength, and supraspinatus contraction rate (R2=0.295), while the factors influencing active shoulder abduction were the VAS score, body weight, grip strength, supraspinatus muscle thickness (drooping position), and supraspinatus contraction rate (R2=0.295). Moreover, the factors influencing the active movement of shoulder external rotation were age, VAS score, body weight, grip strength, and supraspinatus muscle thickness (drooping position) (R2=0.258). There were no intentional results from multiple linear regressions for shoulder extension, adduction, or internal rotation. Conclusion: Pain, weight, grip strength, supraspinatus muscle thickness, and supraspinatus distensibility are the main factors affecting shoulder flexion, abduction, and external rotation. In addition, supraspinatus muscle thickness and contraction rate may be a new index for assessing shoulder dysfunction.","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135192742","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":"HER2+ early breast cancer: from escalation via targeted and postneoadjuvant treatment to de-escalation","authors":"Monika Graeser, Oleg Gluz","doi":"10.1159/000534670","DOIUrl":"https://doi.org/10.1159/000534670","url":null,"abstract":"Background: Human epidermal growth factor receptor 2 positive (HER2+, also referred to as ERBB2+) breast cancer is a subtype historically associated with a particularly poor prognosis. Research into biological and molecular pathomechanisms of breast cancer has resulted in the development and adoption of several therapies targeting HER2. In parallel, various escalation/de-escalation strategies have been examined to further optimize patient outcomes and care. Summary: In this review, we highlighted the landmark trials in the evolution of treatment and management of HER2+ early breast cancer. Key Messages: Continuous research over the last two decades has gradually prolonged survival in patients with early HER2+ early breast cancer. Incorporation of post-neoadjuvant setting into clinical practice improved long-term outcomes in high-risk patients with residual disease after neoadjuvant therapy. In parallel, use of modern anti-HER2 agents may potentially allow omission of chemotherapy without compromising the survival in a significant number of selected patients. Current research focused on exploring the molecular heterogeneity of HER2+ breast cancer resulted in identification of new prognostic and predictive biomarkers which could pave the way towards the development of truly personalized therapy.","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135217933","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":"Use of the gene expression test Prosigna® in premenopausal patients with HR+, HER2- early breast cancer: Correlation of the results with the proliferation marker Ki-67","authors":"Cordula Ziegler, Karl Sotlar, Daniel Maria Hofmann, Thomas Kolben, Nadia Harbeck, Rachel Würstlein","doi":"10.1159/000534634","DOIUrl":"https://doi.org/10.1159/000534634","url":null,"abstract":"<b><i>Introduction:</i></b> In hormone receptor-positive (ER+/PR+) and human epidermal growth factor receptor 2-negative (HER2−) early-stage breast cancer (EBC), gene expression tests such as the Prosigna are increasingly used since classic clinicopathological parameters and the proliferation factor Ki-67 often do not allow a definite therapy decision regarding an adjuvant chemotherapy. While the Prosigna test has been validated for postmenopausal patients, few data are available regarding its use in premenopausal patients. The present study compared the Prosigna test with the Ki-67 index in premenopausal patients. <b><i>Materials and Methods:</i></b> Premenopausal patients with HR+ HER2−, pN0-1, G1-2 EBC were retrospectively enrolled (<i>n</i> = 55). The Prosigna assay was performed in formalin-fixed paraffin-embedded tumor samples of surgical resection specimens. Ki-67 was reassessed in original diagnostic core needle biopsy specimens and defined as low, intermediate, or high with the threshold of &amp;lt;10%, 10–24%, ≥25%. <b><i>Results:</i></b> According to Ki-67, patients were in the low (LR)-, intermediate (IR)-, and high-risk (HR) groups in 40%, 36%, and 24% of the cases. The Prosigna gene signature assay assessed the risk of recurrence as LR for 45% of the patients, IR for 35%, and HR for 20%. The most frequent intrinsic subtypes were luminal A in 73% and luminal B in 24% of the patients. A moderate correlation was found between Prosigna and Ki-67 scores with a Pearson correlation coefficient of 0.51. In the overall cohort, 47% of the Ki-67-based therapy decision would correspond to those based on the Prosigna score. After exclusion of IR patients, matching of low/low or high/high results was observed in 57% of the cases. <b><i>Conclusion:</i></b> According to the present study, there is only limited concordance regarding the risk group stratification between Ki-67 and Prosigna-based risk assessment. The relevance and frequency of premenopausal breast cancer emphasizes the need for further evaluation of gene expression analyses in this setting and the correlation with classic clinicopathological parameters regarding therapy decision-making.","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135993916","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":"Breast Cancer Outome – What have we achieved","authors":"Volker Möbus, Marcus Schmidt","doi":"10.1159/000534589","DOIUrl":"https://doi.org/10.1159/000534589","url":null,"abstract":"","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136079971","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":"Neratinib as extended adjuvant treatment of HER2-positive/HR-positive early breast cancer patients in Germany, Austria and Switzerland: interim results of the prospective, observational ELEANOR study","authors":"Nadia Harbeck, Denise Wrobel, Matthias Zaiss, Jürgen Terhaag, Dagmar Guth, Andrea Distelrath, Mark-Oliver Zahn, Rachel Würstlein, Andreas Lorenz, Rupert Bartsch, Urs Breitenstein, Michael Schwitter, Marija Balic, Christian Jackisch, Volkmar Müller, Gabriel Rinnerthaler, Marcus Schmidt, Khalil Zaman, Timo Schinköthe, Anna Resch, Roberta Valenti, Diana Lueftner","doi":"10.1159/000533657","DOIUrl":"https://doi.org/10.1159/000533657","url":null,"abstract":"Introduction: Prognosis of patients diagnosed with HER2+ early breast cancer (eBC) has substantially improved, but distant recurrences impacting quality of life and survival still occur. One treatment option for extended adjuvant treatment in patients with HER2+/HR+ eBC is neratinib; available in Europe for patients who completed adjuvant trastuzumab-based therapy within 1 year. The ELEANOR study is investigating the real-world use of neratinib in Germany, Austria and Switzerland. Results from an interim analysis of the first 200 patients observed for ≥3 months are reported. Methods: The primary objective of this prospective, multicentre, observational study is to assess patient adherence to neratinib (defined as percentage of patients taking neratinib on ≥75% prescribed days). Secondary objectives are patient characteristics and treatment outcomes. Results: At cut-off (May 2, 2022), 202 patients had been observed for ≥3 months, with neratinib treatment documented for 187 patients (median age 53.0 years; 67.9% at increased risk of disease recurrence). In total 151 (80.7%) patients had received prior neoadjuvant treatment; of these 82 (54.3%) achieved a pathological complete response. Neratinib was initiated at a median 3.6 months after trastuzumab-based treatment, with 36.4% starting at a dose <240 mg/day. Treatment is ongoing for 46.0% of patients, with median treatment duration of 11.2 (interquartile range 0.9–12.0) months. Diarrhoea was the most common adverse event (78.6% any grade, 20.3% Grade ≥3); pharmacologic prophylaxis was used in 85.6% of patients. Conclusions: The pattern of anti-HER2 pretreatment observed reflected the current treatment for HER2+/HR+ eBC in Germany, Austria and Switzerland. These interim results suggest that neratinib as an extended adjuvant is a feasible option after various anti-HER2 pretreatments, and that its tolerability can be managed and improved with proactive diarrhoea management. ClinicalTrials.gov identifier: NCT04388384","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135546529","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":"Predicting Survival of Patients with Nonmetastatic Breast Cancer Based on Fibrinogen-to-Albumin Ratio and Lymphocyte-to-Monocyte Ratio: A Nomogram-Based Assessment.","authors":"Xiao-Yu Chen,&nbsp;Zhi-Qing Long,&nbsp;Han-Ying Huang,&nbsp;Wen Wen,&nbsp;Fei Lin,&nbsp;Ling Guo,&nbsp;Huan-Xin Lin","doi":"10.1159/000531939","DOIUrl":"10.1159/000531939","url":null,"abstract":"<p><strong>Background: </strong>Parameters of systemic inflammation have received attention as prognostic surrogates in various malignant tumors. Fibrinogen-to-albumin ratio (FAR) and lymphocyte-to-monocyte ratio (LMR) correlate with tumor growth and dissemination. We aimed to bring the combination of FAR and LMR (FAR-LMR) together to establish novel nomograms for survival and recurrence in nonmetastatic breast cancer patients.</p><p><strong>Methods: </strong>We retrospectively recruited 461 female patients with nonmetastatic breast cancer from January 2011 to December 2013 in our hospital and randomly assigned them into the training cohort (<i>N</i> = 318) and the validation cohort (<i>N</i> = 143). The potential predictive factors for overall survival (OS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were assessed by Cox proportional hazards models and log-rank test.</p><p><strong>Results: </strong>Elevated FAR was associated with poor OS (<i>p</i> < 0.001) and DMFS (<i>p</i> = 0.02), whereas increased LMR was associated with satisfactory OS (<i>p</i> = 0.01) and LRFS (<i>p</i> = 0.01). High FAR combined with low LMR was associated with less favorable OS (<i>p</i> = 0.001), LRFS (<i>p</i> = 0.005), and DMFS (<i>p</i> = 0.003) Based on multivariate analysis, FAR-LMR, tumor size, lymph node metastasis, age, and pathologic status contributed to prognostic nomograms of OS, DMFS, and LRFS. Nomograms presented exceptional performance for 3-, 5-, and 8-year OS, DMFS, and LRFS prediction compared with clinical TNM stage. The C-index was significantly higher than that of TNM stage, either of FAR or LMR (3-year: 0.709 vs. 0.621 vs. 0.544 vs. 0.641, 5-year: 0.761 vs. 0.597 vs. 0.605 vs. 0.677, 8-year: 0.84 vs. 0.62 vs. 0.539 vs. 0.623).</p><p><strong>Conclusions: </strong>We developed and validated a convenient predictive model for the survival outcomes of patients with nonmetastatic breast cancer. The nomograms can be utilized as auxiliary tools to provide prognostic information.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44420204","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}