{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T13:42:25Z","timestamp":1760708545909,"version":"build-2065373602"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82070684"],"award-info":[{"award-number":["82070684"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Guangdong Natural Science Fund for Outstanding Youth Scholars","award":["2020B151502005"],"award-info":[{"award-number":["2020B151502005"]}]},{"name":"the Bethune Aixikang Distinguished Surgical Fund project","award":["HZB-20190528-5"],"award-info":[{"award-number":["HZB-20190528-5"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Surg Onc"],"DOI":"10.1186\/s12957-025-04042-3","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T12:51:23Z","timestamp":1760705483000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Oncologic outcomes of patients with negative nodal involvement on preoperative imaging undergoing surgery for gastric cancer"],"prefix":"10.1186","volume":"23","author":[{"given":"Zhizhong","family":"Xiong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia Bo","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huashe","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jintuan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Lian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"issue":"3","key":"4042_CR1","first-page":"209","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209\u201349.","journal-title":"CA Cancer J Clin"},{"issue":"16","key":"4042_CR2","doi-asserted-by":"publisher","first-page":"2452","DOI":"10.3748\/wjg.v29.i16.2452","volume":"29","author":"W-J Yang","year":"2023","unstructured":"Yang W-J, Zhao H-P, Yu Y, et al. Updates on global epidemiology, risk and prognostic factors of gastric cancer. World J Gastroenterol. 2023;29(16):2452.","journal-title":"World J Gastroenterol"},{"issue":"12","key":"4042_CR3","doi-asserted-by":"publisher","first-page":"e943","DOI":"10.1016\/S2468-2667(23)00211-6","volume":"8","author":"J Qi","year":"2023","unstructured":"Qi J, Li M, Wang L, et al. National and subnational trends in cancer burden in China, 2005-20: an analysis of National mortality surveillance data. Lancet Public Health. 2023;8(12):e943\u201355.","journal-title":"Lancet Public Health"},{"key":"4042_CR4","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1007\/BF02574500","volume":"9","author":"E Bando","year":"2002","unstructured":"Bando E, Yonemura Y, Taniguchi K, Fushida S, Fujimura T, Miwa K. Outcome of ratio of lymph node metastasis in gastric carcinoma. Ann Surg Oncol. 2002;9:775\u201384.","journal-title":"Ann Surg Oncol"},{"issue":"14","key":"4042_CR5","doi-asserted-by":"publisher","first-page":"3967","DOI":"10.3748\/wjg.v20.i14.3967","volume":"20","author":"J-Y Deng","year":"2014","unstructured":"Deng J-Y, Liang H. Clinical significance of lymph node metastasis in gastric cancer. World J Gastroenterology: WJG. 2014;20(14):3967.","journal-title":"World J Gastroenterology: WJG"},{"key":"4042_CR6","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.649035","volume":"11","author":"J Wang","year":"2021","unstructured":"Wang J, Wang L, Li S, et al. Risk factors of lymph node metastasis and its prognostic significance in early gastric cancer: a multicenter study. Front Oncol. 2021;11:649035.","journal-title":"Front Oncol"},{"key":"4042_CR7","doi-asserted-by":"publisher","first-page":"3077","DOI":"10.1245\/s10434-010-1362-z","volume":"17","author":"K Washington","year":"2010","unstructured":"Washington K. Of the AJCC cancer staging manual: stomach. Ann Surg Oncol. 2010;17:3077\u20139.","journal-title":"Ann Surg Oncol"},{"key":"4042_CR8","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1007\/s10120-016-0601-9","volume":"20","author":"T Sano","year":"2017","unstructured":"Sano T, Coit DG, Kim HH, et al. Proposal of a new stage grouping of gastric cancer for TNM classification: international gastric cancer association staging project. Gastric Cancer. 2017;20:217\u201325.","journal-title":"Gastric Cancer"},{"key":"4042_CR9","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.806162","volume":"11","author":"S Kinami","year":"2021","unstructured":"Kinami S, Saito H, Takamura H. Significance of lymph node metastasis in the treatment of gastric cancer and current challenges in determining the extent of metastasis. Front Oncol. 2021;11:806162.","journal-title":"Front Oncol"},{"issue":"2","key":"4042_CR10","doi-asserted-by":"publisher","first-page":"167","DOI":"10.6004\/jnccn.2022.0008","volume":"20","author":"JA Ajani","year":"2022","unstructured":"Ajani JA, D\u2019Amico TA, Bentrem DJ, et al. Gastric cancer, version 2.2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2022;20(2):167\u201392.","journal-title":"J Natl Compr Canc Netw"},{"issue":"8","key":"4042_CR11","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1002\/cac2.12193","volume":"41","author":"FH Wang","year":"2021","unstructured":"Wang FH, Zhang XT, Li YF, et al. The Chinese society of clinical oncology (CSCO): clinical guidelines for the diagnosis and treatment of gastric cancer, 2021. Cancer Commun. 2021;41(8):747\u201395.","journal-title":"Cancer Commun"},{"issue":"null","key":"4042_CR12","doi-asserted-by":"publisher","first-page":"8755","DOI":"10.2147\/CMAR.S200318","volume":"11","author":"J Chen","year":"2019","unstructured":"Chen J, Zhou C, He M, Zhen Z, Wang J, Hu X. A Meta-Analysis and systematic review of accuracy of endoscopic ultrasound for N staging of gastric cancers. Cancer Manage Res. 2019;11(null):8755\u201364.","journal-title":"Cancer Manage Res"},{"key":"4042_CR13","doi-asserted-by":"publisher","first-page":"3002","DOI":"10.1245\/s10434-014-3667-9","volume":"21","author":"H Fujikawa","year":"2014","unstructured":"Fujikawa H, Yoshikawa T, Hasegawa S, et al. Diagnostic value of computed tomography for staging of clinical T1 gastric cancer. Ann Surg Oncol. 2014;21:3002\u20137.","journal-title":"Ann Surg Oncol"},{"issue":"3","key":"4042_CR14","doi-asserted-by":"publisher","first-page":"149","DOI":"10.5230\/jgc.2013.13.3.149","volume":"13","author":"SH Kim","year":"2013","unstructured":"Kim SH, Kim JJ, Lee JS, et al. Preoperative N staging of gastric cancer by stomach protocol computed tomography. J Gastric Cancer. 2013;13(3):149\u201356.","journal-title":"J Gastric Cancer"},{"issue":"1","key":"4042_CR15","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11010134","volume":"11","author":"BS Ungureanu","year":"2021","unstructured":"Ungureanu BS, Sacerdotianu VM, Turcu-Stiolica A, Cazacu IM, Saftoiu A. Endoscopic ultrasound vs. Computed tomography for gastric cancer staging: A network Meta-Analysis. Diagnostics. 2021;11(1):134.","journal-title":"Diagnostics"},{"issue":"7","key":"4042_CR16","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1016\/j.annonc.2020.04.003","volume":"31","author":"D Dong","year":"2020","unstructured":"Dong D, Fang MJ, Tang L, et al. Deep learning radiomic nomogram can predict the number of lymph node metastasis in locally advanced gastric cancer: an international multicenter study. Ann Oncol. 2020;31(7):912\u201320.","journal-title":"Ann Oncol"},{"issue":"9","key":"4042_CR17","doi-asserted-by":"publisher","first-page":"6523","DOI":"10.3390\/curroncol29090513","volume":"29","author":"D Ma","year":"2022","unstructured":"Ma D, Zhang Y, Shao X, Wu C, Wu J. PET\/CT for predicting occult lymph node metastasis in gastric cancer. Curr Oncol. 2022;29(9):6523\u201339.","journal-title":"Curr Oncol"},{"key":"4042_CR18","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1007\/BF01651001","volume":"24","author":"S Natsugoe","year":"1994","unstructured":"Natsugoe S, Aikou T, Shimada M, et al. Occult lymph node metastasis in gastric cancer with submucosal invasion. Surg Today. 1994;24:870\u20135.","journal-title":"Surg Today"},{"issue":"5","key":"4042_CR19","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1159\/000433543","volume":"89","author":"A Tavares","year":"2015","unstructured":"Tavares A, Monteiro-Soares M, Viveiros F, Maciel Barbosa J, Dinis-Ribeiro M. Occult tumor cells in lymph nodes of patients with gastric cancer: a systematic review on their prevalence and predictive role. Oncology. 2015;89(5):245\u201354.","journal-title":"Oncology"},{"key":"4042_CR20","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.898640","volume":"12","author":"X Zhang","year":"2022","unstructured":"Zhang X, Yang D, Wei Z, et al. Establishment of a nomogram for predicting lymph node metastasis in patients with early gastric cancer after endoscopic submucosal dissection. Front Oncol. 2022;12:898640.","journal-title":"Front Oncol"},{"issue":"1","key":"4042_CR21","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-019-1778-2","volume":"18","author":"X-Y Yin","year":"2020","unstructured":"Yin X-Y, Pang T, Liu Y, et al. Development and validation of a nomogram for preoperative prediction of lymph node metastasis in early gastric cancer. World J Surg Oncol. 2020;18(1):2.","journal-title":"World J Surg Oncol"},{"issue":"7","key":"4042_CR22","doi-asserted-by":"publisher","first-page":"8567","DOI":"10.1007\/s13277-015-4721-3","volume":"37","author":"Y-W Wang","year":"2016","unstructured":"Wang Y-W, Zhu M-L, Wang R-F, et al. Predictable factors for lymph node metastasis in early gastric cancer analysis of clinicopathologic factors and biological markers. Tumor Biol. 2016;37(7):8567\u201378.","journal-title":"Tumor Biol"},{"key":"4042_CR23","doi-asserted-by":"publisher","DOI":"10.1093\/gastro\/goac080","volume":"11","author":"Y Yang","year":"2023","unstructured":"Yang Y, Chen H, Ji M, et al. A new radiomics approach combining the tumor and peri-tumor regions to predict lymph node metastasis and prognosis in gastric cancer. Gastroenterol Rep. 2023;11:goac080.","journal-title":"Gastroenterol Rep"},{"issue":"4","key":"4042_CR24","doi-asserted-by":"publisher","first-page":"1473","DOI":"10.1007\/s10620-022-07640-3","volume":"68","author":"X Guan","year":"2023","unstructured":"Guan X, Lu N, Zhang J. Computed tomography-based deep learning nomogram can accurately predict lymph node metastasis in gastric cancer. Dig Dis Sci. 2023;68(4):1473\u201381.","journal-title":"Dig Dis Sci"},{"issue":"2","key":"4042_CR25","first-page":"93","volume":"67","author":"MB Amin","year":"2017","unstructured":"Amin MB, Greene FL, Edge SB, et al. The eighth edition AJCC cancer staging manual: continuing to build a bridge from a population-based to a more personalized approach to cancer staging. CA Cancer J Clin. 2017;67(2):93\u20139.","journal-title":"CA Cancer J Clin"},{"issue":"5","key":"4042_CR26","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1016\/j.ejrad.2016.03.003","volume":"85","author":"Y Kawanaka","year":"2016","unstructured":"Kawanaka Y, Kitajima K, Fukushima K, et al. Added value of pretreatment (18)F-FDG PET\/CT for staging of advanced gastric cancer: comparison with contrast-enhanced MDCT. Eur J Radiol. 2016;85(5):989\u201395.","journal-title":"Eur J Radiol"},{"issue":"3","key":"4042_CR27","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1148\/radiology.197.3.7480743","volume":"197","author":"T Fukuya","year":"1995","unstructured":"Fukuya T, Honda H, Hayashi T, et al. Lymph-node metastases: efficacy for detection with helical CT in patients with gastric cancer. Radiology. 1995;197(3):705\u201311.","journal-title":"Radiology"},{"issue":"37","key":"4042_CR28","doi-asserted-by":"publisher","first-page":"59630","DOI":"10.18632\/oncotarget.10732","volume":"7","author":"L-Y Zhao","year":"2016","unstructured":"Zhao L-Y, Yin Y, Li X, et al. A nomogram composed of clinicopathologic features and preoperative serum tumor markers to predict lymph node metastasis in early gastric cancer patients. Oncotarget. 2016;7(37):59630.","journal-title":"Oncotarget"},{"issue":"5","key":"4042_CR29","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1016\/j.surg.2021.10.049","volume":"171","author":"F Cai","year":"2022","unstructured":"Cai F, Dong Y, Wang P, et al. Risk assessment of lymph node metastasis in early gastric cancer: establishment and validation of a seven-point scoring model. Surgery. 2022;171(5):1273\u201380.","journal-title":"Surgery"},{"issue":"6","key":"4042_CR30","first-page":"411","volume":"113","author":"Z Wang","year":"2021","unstructured":"Wang Z, Liu J, Luo Y, et al. Establishment and verification of a nomogram for predicting the risk of lymph node metastasis in early gastric cancer. Rev Esp Enferm Dig. 2021;113(6):411\u20137.","journal-title":"Rev Esp Enferm Dig"},{"issue":"12","key":"4042_CR31","doi-asserted-by":"publisher","first-page":"6843","DOI":"10.21873\/anticanres.13901","volume":"39","author":"T Kosuga","year":"2019","unstructured":"Kosuga T, Konishi T, Kubota T, et al. Value of prognostic nutritional index as a predictor of lymph node metastasis in gastric cancer. Anticancer Res. 2019;39(12):6843\u20139.","journal-title":"Anticancer Res"},{"key":"4042_CR32","doi-asserted-by":"publisher","first-page":"974","DOI":"10.1245\/s10434-018-6342-8","volume":"25","author":"K Fujiya","year":"2018","unstructured":"Fujiya K, Kawamura T, Omae K, et al. Impact of malnutrition after gastrectomy for gastric cancer on long-term survival. Ann Surg Oncol. 2018;25:974\u201383.","journal-title":"Ann Surg Oncol"},{"issue":"8","key":"4042_CR33","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1080\/01635581.2014.956261","volume":"66","author":"M Sachlova","year":"2014","unstructured":"Sachlova M, Majek O, Tucek S. Prognostic value of scores based on malnutrition or systemic inflammatory response in patients with metastatic or recurrent gastric cancer. Nutr Cancer. 2014;66(8):1362\u201370.","journal-title":"Nutr Cancer"},{"issue":"4","key":"4042_CR34","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1080\/01443615.2017.1281895","volume":"37","author":"Y Kadan","year":"2017","unstructured":"Kadan Y, Calvino AS, Katz A, Katz S, Moore RG. Predictors for lymph nodes involvement in low risk endometrial cancer. J Obstet Gynaecol. 2017;37(4):514\u20138.","journal-title":"J Obstet Gynaecol"},{"issue":"3","key":"4042_CR35","doi-asserted-by":"publisher","first-page":"323","DOI":"10.4103\/aja.aja_70_19IF","volume":"22","author":"AB Porcaro","year":"2020","unstructured":"Porcaro AB, Tafuri A, Sebben M, et al. High body mass index predicts multiple prostate cancer lymph node metastases after radical prostatectomy and extended pelvic lymph node dissection. Asian J Androl. 2020;22(3):323.","journal-title":"Asian J Androl"},{"key":"4042_CR36","doi-asserted-by":"publisher","DOI":"10.3390\/nu16111639","author":"JK Triantafillidis","year":"2024","unstructured":"Triantafillidis JK, Papakontantinou J, Antonakis P, Konstadoulakis MM, Papalois AE. Enteral nutrition in operated-on gastric cancer patients: an update. Nutrients. 2024. https:\/\/doi.org\/10.3390\/nu16111639.","journal-title":"Nutrients"},{"issue":"9","key":"4042_CR37","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1002\/hed.24452","volume":"38","author":"M Mermod","year":"2016","unstructured":"Mermod M, Bongiovanni M, Petrova TV, et al. Prediction of occult lymph node metastasis in squamous cell carcinoma of the oral cavity and the oropharynx using peritumoral prospero homeobox protein 1 lymphatic nuclear quantification. Head Neck. 2016;38(9):1407\u201315.","journal-title":"Head Neck"},{"issue":"3","key":"4042_CR38","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21030854","volume":"21","author":"C Idel","year":"2020","unstructured":"Idel C, Ribbat-Idel J, Kuppler P, et al. EVI1 as a marker for lymph node metastasis in HNSCC. Int J Mol Sci. 2020;21(3):854.","journal-title":"Int J Mol Sci"},{"issue":"1","key":"4042_CR39","doi-asserted-by":"publisher","DOI":"10.1038\/s42003-023-04437-6","volume":"6","author":"B Dharavath","year":"2023","unstructured":"Dharavath B, Butle A, Pal A, et al. Role of miR-944\/MMP10\/AXL-axis in lymph node metastasis in tongue cancer. Commun Biol. 2023;6(1):57.","journal-title":"Commun Biol"},{"key":"4042_CR40","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s10020-021-00345-9","volume":"27","author":"B Zhou","year":"2021","unstructured":"Zhou B, Zhou Y, Liu Y, et al. Association of CASC18\/miR-20a-3p\/TGFB2 CeRNA axis with occult lymph node metastasis in tongue squamous cell carcinoma. Mol Med. 2021;27:1\u201313.","journal-title":"Mol Med"},{"issue":"3","key":"4042_CR41","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1016\/j.ejso.2021.09.003","volume":"48","author":"F Roviello","year":"2022","unstructured":"Roviello F, Marano L, Ambrosio MR, et al. Signet ring cell percentage in poorly cohesive gastric cancer patients: a potential novel predictor of survival. Eur J Surg Oncol. 2022;48(3):561\u20139.","journal-title":"Eur J Surg Oncol"},{"key":"4042_CR42","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.897218","volume":"12","author":"L Marano","year":"2022","unstructured":"Marano L, Ambrosio MR, Resca L, et al. The percentage of signet ring cells is inversely related to aggressive behavior and poor prognosis in mixed-type gastric cancer. Front Oncol. 2022;12:897218.","journal-title":"Front Oncol"},{"issue":"1","key":"4042_CR43","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1007\/s00423-023-02996-0","volume":"408","author":"M Yordanagil","year":"2023","unstructured":"Yordanagil M, Ercan M, Senturk A, Elcin B. Prognostic significance of common hepatic artery lymph node metastasis in gastric cancer. Langenbecks Arch Surg. 2023;408(1):247.","journal-title":"Langenbecks Arch Surg"},{"key":"4042_CR44","doi-asserted-by":"publisher","first-page":"3927","DOI":"10.1245\/s10434-013-3021-7","volume":"20","author":"J-y Huang","year":"2013","unstructured":"Huang J-y, Xu Y-y, Li M, et al. The prognostic impact of occult lymph node metastasis in node-negative gastric cancer: a systematic review and meta-analysis. Ann Surg Oncol. 2013;20:3927\u201334.","journal-title":"Ann Surg Oncol"},{"issue":"8","key":"4042_CR45","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1016\/j.ejso.2016.03.016","volume":"42","author":"Y Yonemura","year":"2016","unstructured":"Yonemura Y, Canbay E, Li Y, et al. A comprehensive treatment for peritoneal metastases from gastric cancer with curative intent. Eur J Surg Oncol. 2016;42(8):1123\u201331.","journal-title":"Eur J Surg Oncol"}],"container-title":["World Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-025-04042-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12957-025-04042-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-025-04042-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T13:04:31Z","timestamp":1760706271000},"score":1,"resource":{"primary":{"URL":"https:\/\/wjso.biomedcentral.com\/articles\/10.1186\/s12957-025-04042-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,17]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4042"],"URL":"https:\/\/doi.org\/10.1186\/s12957-025-04042-3","relation":{},"ISSN":["1477-7819"],"issn-type":[{"value":"1477-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,17]]},"assertion":[{"value":"17 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The requirement for informed consent for this study was waived, and approval was granted by the Medical Ethics Committee of the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"378"}}