Oral oncology最新文献

{"title":"Trans-hairline robotic neck dissection and robotic microvascular free flap reconstruction in oral cavity cancer","authors":"Velda Ling-Yu CHOW,&nbsp;Valerie Wai-Yee HO,&nbsp;Arthur Shing-Ho LO","doi":"10.1016/j.oraloncology.2025.107819","DOIUrl":"10.1016/j.oraloncology.2025.107819","url":null,"abstract":"<div><h3>Background</h3><div>A report on the feasibility of sequential robotic-assisted neck dissection and robotic micro-surgical free flap reconstruction via a <em>trans</em>-hairline approach in oral cavity cancer patients.</div></div><div><h3>Material and methods</h3><div>A patient with cT2N0 right tongue squamous cell carcinoma is used for illustration.</div></div><div><h3>Results</h3><div>A <em>trans</em>-hairline incision is used. Subplatysmal flaps are raised and levels I-III cervical lymph nodes are exposed. Da Vinci Xi robotic system is then docked via <em>trans</em>-hairline incision for neck dissection followed by <em>trans</em>-oral hemi-glossectomy. Skin island of free anterolateral thigh flap is used to reconstruct intra-oral mucosal defect. Flap pedicle is passed to the neck medial to mandible for microvascular anastomosis using the Symani micro-robotic surgical system via <em>trans</em>-hairline incision.</div></div><div><h3>Conclusion</h3><div>Trans-hairline robotic-assisted neck dissection and robotic microvascular free flap surgery is feasible and safe with good cosmetic and functional outcomes in oral cavity cancer patients.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107819"},"PeriodicalIF":3.9,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological considerations in profiling the immune microenvironment and HPV status of oral multiple primary cancers","authors":"Shanshan Yuan,&nbsp;Jingjing Gao","doi":"10.1016/j.oraloncology.2025.107822","DOIUrl":"10.1016/j.oraloncology.2025.107822","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107822"},"PeriodicalIF":3.9,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of metastasis and nodal disease in tongue and buccal carcinomas: Case-based reflections in Delhi NCR Region","authors":"Kripa Bajaj ,&nbsp;Ramya Ramadoss ,&nbsp;Sandhya Sundar ,&nbsp;Suganya Panneer Selvam ,&nbsp;Hema Shree K.","doi":"10.1016/j.oraloncology.2025.107816","DOIUrl":"10.1016/j.oraloncology.2025.107816","url":null,"abstract":"<div><h3>Background</h3><div>Oral squamous cell carcinoma (OSCC) is a large source of cancer-related morbidity in India especially when it involves the tongue and the buccal mucosa. Despite the fact that TNM staging provides a global framework, regional patterns of metastasis, comorbidity interaction and concordance between imaging and pathology are not uniformly represented. This study will investigate nodal disease patterns in a group of people in the Delhi National Capital Region (NCR) and will suggest more specific treatments. The research aims to facilitate early diagnosis and intervention pathways and to reduce inequality in healthcare service provision.</div></div><div><h3>Methods</h3><div>Twenty patients with OSCC who had been diagnosed between 2023 and 2025 were the subjects of a retrospective study conducted on tertiary oncology centres in Delhi NCR. Inclusion criteria were confirmation of primary OSCC of the tongue or buccal mucosa, availability of PET −CT or MRI images, full TNM staging, and comorbidity information. Data visualization included heatmaps, scatter plot, cluster diagram and radar charts. Along with the imaging concordance, tumour site, the size of the lesion, nodal involvement, and the burden of comorbidity were evaluated.</div></div><div><h3>Results</h3><div>Bilateral nodal involvement was higher in the Tongue OSCC, mostly at Level II and III, but the tumours of the buccal mucosa were mostly limited to Level Ib unilateral. Nodal burden was much higher in lesions of around 3.5 cm. Comorbidities (diabetes and chronic kidney disease) were also related to higher FDG uptake and necrosis, but the relationships were not statistically significant. PET-CT had 85 percent agreement with the pathology of the surgery. The decision of treatment was based on the staging with surgery being the preferred treatment option in early disease and chemoradiation in advanced ones.</div></div><div><h3>Conclusion</h3><div>The site and size of tumour have a significant impact on nodal dissemination in OSCC. Bilateral neck dissection can be a wise option in case of early tongue lesions involving the midline but selective unilateral dissection is adequate in selecting cases involving the buccal lesions. It is necessary to couple comorbidity profiling with imaging results when planning pre-treatment. In this study, health systems, health equity, and collaborative oncology care are strengthened.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107816"},"PeriodicalIF":3.9,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: Stroke risk after head and neck cancer diagnosis and treatment in a Real-World clinical cohort","authors":"Cunxi Zou","doi":"10.1016/j.oraloncology.2025.107705","DOIUrl":"10.1016/j.oraloncology.2025.107705","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107705"},"PeriodicalIF":3.9,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebrovascular events after head and neck radiation therapy: A systematic review and Meta-Analysis","authors":"Kennedy Ayoo ,&nbsp;Elliot Koo ,&nbsp;Noémie Villemure-Poliquin ,&nbsp;Rui Fu ,&nbsp;Jonathan C Irish ,&nbsp;Thomas Lindsay ,&nbsp;Antoine Eskander","doi":"10.1016/j.oraloncology.2025.107810","DOIUrl":"10.1016/j.oraloncology.2025.107810","url":null,"abstract":"<div><h3>Background</h3><div>Several studies have demonstrated increased risk of cerebrovascular events, including carotid stenosis, stroke &amp; transient ischemic attack, following head and neck radiation therapy (RT) for head and neck cancer (HNC). This systematic review reports the incidence of cerebrovascular events (CVEs) and the relative rate (RR) of ischemic stroke in patients treated with RT compared to non-RT populations.</div></div><div><h3>Methods</h3><div>A comprehensive database search identified publications reporting the incidence or RR of CVEs following RT. Citations were retrieved, and data was extracted where appropriate. Risk of bias was assessed, and <em>meta</em>-analyses were conducted to present pooled estimates of the incidence of CVEs after RT and the RR of ischemic stroke.</div></div><div><h3>Results</h3><div>2,598 citations were retrieved, of which 50 met criteria for inclusion. The incidence of carotid stenosis ranged from 0 %-40 % over median follow-up duration of 6–68 months (mean = 6–150 months). The incidence of ischemic stroke was 8.98 per 1,000 person-years (95 % CI: 4.66 – 17.30). The relative rate of ischemic stroke was higher in patients treated with radiation therapy with a HR of 1.33 (95 % CI: 1.21 – 1.45) when compared to a reference population (HR of 1) of those treated with surgery and a HR of 1.29 (95 % CI: 1.13 – 1.47) when compared to the general population as the reference group.</div></div><div><h3>Conclusions</h3><div>HNC patients face an increased risk of ischemic stroke following head and neck radiation therapy. The magnitude of this heightened risk remains elusive in the contemporary era of intensity-modulated radiation techniques and should be addressed in future studies.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107810"},"PeriodicalIF":3.9,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival rates and oncologic outcomes of adeno squamous carcinoma of oral cavity: A systematic review","authors":"Francesco Chiari ,&nbsp;Andrea Luigi Camillo Carobbio ,&nbsp;Marco Ferrari ,&nbsp;Piero Nicolai ,&nbsp;Claudio Donadio Caporale ,&nbsp;Pierre Guarino","doi":"10.1016/j.oraloncology.2025.107821","DOIUrl":"10.1016/j.oraloncology.2025.107821","url":null,"abstract":"<div><h3>Background</h3><div>Adenosquamous carcinoma (ASC) of the oral cavity is an uncommon and aggressive malignancy characterized by squamous and glandular histologic components. Due to its rarity, clinical behavior and oncologic outcomes remain poorly defined.</div></div><div><h3>Methods</h3><div>A systematic literature review was conducted according to PRISMA 2020 guidelines. Comprehensive searches of Embase, PubMed, Scopus, and Cochrane Library identified studies published between 1968 and 2025.</div></div><div><h3>Results</h3><div>Sixty-one patients were included. The most frequent subsites were tongue (43 %) and floor of mouth (31 %). Transoral surgery was performed in 93 % of cases, with neck dissection in 50 %. Adjuvant therapy was administered in 27 %. Despite 57 % presenting with early-stage disease, recurrence occurred in 42 %: local (36 %), regional (20 %), and distant (10 %). Local recurrence was significantly associated with advanced stage (p = 0.007) and subsite (p = 0.028), highest in floor of mouth (59 %) and gingiva (50 %). Perineural invasion (PNI), lymphovascular invasion (LVI), and positive margins correlated with recurrence and reduced time to recurrence (TTR), disease-specific survival (DSS), and overall survival (OS) (p &lt; 0.001). Two-year TTR, DSS, and OS rates were 47 %, 74 %, and 70 %, respectively—lower than reported for conventional oral squamous carcinoma. Because oral ASC is rare, the evidence is primarily derived from case reports and small retrospective series.</div></div><div><h3>Conclusions</h3><div>Oral ASC demonstrates high recurrence and poor survival, even in early-stage disease. Prognosis is strongly influenced by PNI, LVI, and margin status, as well as tumor subsite. These findings highlight oral ASC as a distinct and particularly aggressive entity.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107821"},"PeriodicalIF":3.9,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is 55 years an optimal age cutoff point for clinical staging in T1 papillary thyroid cancer?","authors":"Daixing Hu ,&nbsp;Zhuolin Dai ,&nbsp;Yang Feng ,&nbsp;Xinliang Su ,&nbsp;Chun Huang","doi":"10.1016/j.oraloncology.2025.107817","DOIUrl":"10.1016/j.oraloncology.2025.107817","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to determine the optimal age cutoff for T1 papillary thyroid cancer (PTC), with a particular focus on the T1a and T1b subgroups.</div></div><div><h3>Methods</h3><div>A retrospective review of electronic medical records was conducted to identify patients who underwent thyroidectomy at our institution from January 2013 to December 2018.</div></div><div><h3>Results</h3><div>The study cohort consisted of 2,862 patients, including 765 men (26.7 %) and 2,097 women (73.3 %). Survival analysis demonstrated significantly poorer recurrence-free survival (RFS) in patients aged ≥55 years (p &lt; 0.001). Patients were stratified into T1 (tumor size ≤2 cm, n = 2,328) and non-T1 (tumor size &gt;2 cm, n = 534) subgroups. Among the non-T1 subgroup, older patients exhibited significantly inferior RFS, consistent with the overall cohort (p &lt; 0.001). However, this difference was not observed in the T1 subgroup (p = 0.079). Within the T1 PTC subgroup, significant differences were identified between T1a and T1b patients concerning gender distribution, tumor size, clinical lymph node-positive status (cN1), total thyroidectomy, bilaterality, presence of Hashimoto’s thyroiditis, central lymph node metastasis, lateral lymph node metastasis, and radioiodine treatment (all p &lt; 0.05). Further analysis indicated that when stratified by an age cutoff of 65 years, the prognosis for T1b patients was statistically significant (p = 0.018), whereas the prognosis for T1a patients was not statistically significant (p = 0.64).</div></div><div><h3>Conclusion</h3><div>The clinicopathologic characteristics of T1b patients differ significantly from those of T1a patients. Age may not be a critical factor in the prognostic staging system for T1a PTC patients, whereas 65 years appears to be a more appropriate age cutoff for T1b patients.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107817"},"PeriodicalIF":3.9,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment and outcome for 2,111 patients with vermilion lip squamous cell carcinoma: A nationwide, population-based study from the SweHNCR","authors":"A. Hafström ,&nbsp;E. Hammerlid ,&nbsp;M. Beran ,&nbsp;M. Olin ,&nbsp;A. Högmo ,&nbsp;L. Farnebo","doi":"10.1016/j.oraloncology.2025.107818","DOIUrl":"10.1016/j.oraloncology.2025.107818","url":null,"abstract":"<div><h3>Background and importance</h3><div>The major risk factor for vermilion lip squamous cell carcinoma (vlSCC) is excessive sunlight exposure. Population-based studies on treatment and outcome are lacking.</div></div><div><h3>Methods</h3><div>This is a nation-wide, population-based study of treatment and outcome from prospectively recorded data for 2,111 vlSCC registered in the Swedish Head and Neck Cancer Register (SweHNCR) diagnosed 2008–2022.</div></div><div><h3>Results</h3><div>The age standardized incidence increased with 34 % between 2008 and 2022, from 1.14 to 1.53 per 100,000 (19 % for males and 55 % for females). Median age at diagnosis was 76 years and 72.4 % had good performance status. Males predominated (57.1 %). Lower lip vlSCC comprised 82.6 % and upper 8.6 %. Most had T1 (81.7 %) or T2 (13.5 %) tumors and few had regional (2.7 %) or distant (0.1 %) metastases. The 5-year observed overall survival was 70.5 % (95 % CI 68.4–72.6) and relative survival 90.8 % (95 % CI 88.2–93.7).</div><div>Treatment data were registered in 1,948 cases and 97.5 % (1,900) had a curative intent, whereof 88.5 % had surgery, 7.3 % radiotherapy, and 4.2 % combination treatment. Recurrences were registered in 5.6 % (48.6 % local, 42.1 % regional) whereof 15.9 % after three years. Stage I recurred after median 17 (IQR 9–28) months whereas stage II and III after 10 months (7–17 and 9–13, respectively). Advanced age (p &lt; 0.001), poor performance status (p &lt; 0.001), male sex (p = 0.002), high stage (p = 0.041), and only radiotherapy (p = 0.007) remained as independent prognostic factors for mortality.</div></div><div><h3>Conclusion</h3><div>Females had higher incidence increase than males. Advanced age, poor performance status, male sex, advanced disease, and radiotherapy only were independent prognostic factors for mortality.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107818"},"PeriodicalIF":3.9,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot study of a digital workflow for navigated tumor bed marking to reduce clinical target volume during adjuvant radiotherapy for oral squamous cell carcinoma","authors":"Frederik Holdorf ,&nbsp;Henning Schliephake ,&nbsp;Kathi Goldstein ,&nbsp;Lennart Johannes Gruber ,&nbsp;Phillipp Brockmeyer ,&nbsp;Martin Leu ,&nbsp;Stefan Rieken ,&nbsp;Boris Schminke","doi":"10.1016/j.oraloncology.2025.107820","DOIUrl":"10.1016/j.oraloncology.2025.107820","url":null,"abstract":"<div><h3>Purpose</h3><div>The treatment of advanced-stage oral squamous cell carcinoma (OSCC) often requires adjuvant radiotherapy to improve the survival rate. Accurately defining the clinical target volume (CTV) is critical for radiation treatment to maximize the radiation dose and minimize negative side effects. However, precise planning remains difficult because of postoperative anatomical changes, which may lead to oversized volumes with increased collateral damage to adjacent tissues. The aim of this study is to suggest a digital planning algorithm to improve the precision of CTV definition.</div></div><div><h3>Methods</h3><div>In this pilot study, intraoperative digital tracings of tumor resection margins were located in the preoperative computed tomography (CT) datasets of ten patients with advanced OSCC using the Brainlab Curve navigation system. OSCCs of the tongue were excluded from this analysis because of their unique anatomical features. The preoperative scans with digital tracings were aligned with the postoperative scans to identify the desired CTV. The digitally navigated CTVs were compared with the CTVs resulting from conventional planning.</div></div><div><h3>Results</h3><div>Our findings demonstrated that the digital workflow can be easily integrated into the surgical procedure and provides a straightforward and reproducible method to achieve a statistically significant average reduction of 25.71% in the CTV.</div></div><div><h3>Conclusion</h3><div>This innovative approach to digital tracing of the resection margins in postoperative CT scans significantly increases the precision of CTV planning. Clinical studies will be needed to test the oncological safety compared to conventional planning algorithms and the potential for improved outcomes with respect to side effects and quality of life.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107820"},"PeriodicalIF":3.9,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-derived 3D organoid platform for functional assessment of GPC3-targeted CAR T cell cytotoxic activity in head and neck squamous cell carcinoma","authors":"Han-Na Yoon ,&nbsp;Jin-ha Kim ,&nbsp;Doeon Gu ,&nbsp;Jonghyun Lee ,&nbsp;Soo Yoon Kim ,&nbsp;Hye Jin Kim ,&nbsp;Jaehyeon Jeong ,&nbsp;Dongkwan Shin ,&nbsp;Yuh-Seog Jung ,&nbsp;Man Ki Chung ,&nbsp;Sang-Jin Lee ,&nbsp;Sung Yong Choi","doi":"10.1016/j.oraloncology.2025.107814","DOIUrl":"10.1016/j.oraloncology.2025.107814","url":null,"abstract":"<div><h3>Background</h3><div>Head and neck squamous cell carcinoma (HNSCC) remains a therapeutic challenge owing to its marked heterogeneity and limited immunotherapy efficacy, underscoring the need for improved therapeutic strategies and preclinical systems supporting clinical translation.</div></div><div><h3>Method</h3><div>We established a simplified and optimized 3D head and neck cancer organoid (HNCO)–chimeric antigen receptor (CAR) T cell co-culture platform that maintains uniform spheroid architecture (&gt;500 μm) to recapitulate physiological hypoxia while preserving the tumor secretome. CAR T cell cytotoxic activity was assessed through multimodal readouts—structural disruption, ATP-based viability, and granzyme B secretion. Following initial organoid seeding, the workflow proceeded without physical manipulation, enabling concurrent multimodal assessment of CAR T cell activity from a single co-culture.</div></div><div><h3>Results</h3><div>Analysis of The Cancer Genome Atlas (TCGA) data revealed that high glypican-3 (GPC3) expression was associated with poor survival in patients with HNSCC. We generated GPC3-targeted CAR T (GPC3-CAR T) cells. Using our co-culture platform, we evaluated the cytotoxic activity of GPC3-CAR T cells against five HNCOs harboring diverse genetic alterations and variable GPC3 expression. Organoids with high or moderate GPC3 expression consistently exhibited structural disintegration, reduced viability, and increased granzyme B secretion, whereas GPC3-low organoids showed heterogeneous responses.</div></div><div><h3>Conclusions</h3><div>This proof-of-concept study introduces a patient-derived 3D organoid platform for functional assessment of CAR T cell cytotoxic activity in HNSCC. Our findings suggest that GPC3-CAR T therapy may be clinically applicable to subsets of patients with HNSCC, while emphasizing the need for functional validation to account for interpatient heterogeneity in clinical translation.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"172 ","pages":"Article 107814"},"PeriodicalIF":3.9,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145725145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}