基于PMN免疫抑制微环境探讨肝细胞癌转移"因毒致虚"病机的生物学基础OA

Hepatocellular carcinoma(HCC)is a malignant tumor with high incidence rate and mortality globally,and its poor prognosis is closely related to extrahepatic metastasis.Professor Ling Changquan,a nationally renowned traditional Chinese medicine practitioner,proposed that"the rise and fall of cancer toxin"is the core pathogenesis of the occurrence and development of liver cancer."Cancer toxin"damages the body's vital qi,and the deficiency of vital qi cannot restrain cancer toxin,resulting in the spread of cancer toxin and the subsequent impairment of vital qi of target organs.Modern research has found that exosomes,cytokines,and other substances secreted by hepatocellular carcinoma cells induce the formation of a"pre-metastatic niche(PMN)"in the target organs of metastasis,and immune suppression is one of the typical characteristics of PMN,and also one of the biological foundations of the"deficiency of vital qi"theory in traditional Chinese medicine.Local vital qi deficiency fails to suppress the spreading cancer toxin,leading to a"deficiency-toxin mutual aggravation"that accelerates tumor metastasis.Based on the perspective of integrating traditional Chinese and Western medicine,this article constructs a theoretical framework of"cancer toxin-deficiency of vital qi-PMN formation-immune suppression-liver cancer metastasis",reveals the biological basis of the pathogenesis of"deficiency caused by toxin"in traditional Chinese medicine at the local level of the target organs,and provides new ideas and potential targets for the prevention and treatment of liver cancer metastasis.