SHAO Shiliang,NIU Xiaomin,ZHANG Yao,et al.Pathogenesis,Differentiation and Treatment of Pre-Metastatic Niche in Malignant Tumors Based on the Theory of "Toxin Accumulation Damaging Yin"[J].Journal of Traditional Chinese Medicine,2025,66(23):2426-2432.
SHAO Shiliang,NIU Xiaomin,ZHANG Yao,et al.Pathogenesis,Differentiation and Treatment of Pre-Metastatic Niche in Malignant Tumors Based on the Theory of "Toxin Accumulation Damaging Yin"[J].Journal of Traditional Chinese Medicine,2025,66(23):2426-2432.DOI: 10.13288/j.11-2166/r.2025.23.006.
Pathogenesis,Differentiation and Treatment of Pre-Metastatic Niche in Malignant Tumors Based on the Theory of "Toxin Accumulation Damaging Yin"
According to the theory of "toxin accumulation damaging
yin
", the accumulation of pathological products and the disruption of homeostasis in the pre-metastatic niche (PMN) of malignant tumors correspond to "toxin accumulation" and "
yin
damage" respectively. During the dynamic evolution of PMN, the main pathogenesis in the initial stage is healthy
qi
deficiency and phlegm congestion, obstruction in the
ying
(营)
and
wei
(卫) level, for which the therapeutic approach is fortifying spleen and warming
yang
, reinforcing healthy
qi
, consolidating the root, and assissting in resolving phlegm. In the progression stage, the predominant mechanism is mutual binding of phlegm and stasis, with collateral damage and pathological transformation. Treatment should focus on resolving phlegm and eliminating stasis, using insect-derived medicinals to attack accumulation and block pathological transmission. In the terminal stage, the main pathogenesis involves phlegm-stasis transforming into fire, with depletion of
qi
and
yin
, for which it is suggested to replenish
qi
and nourish
yin
, combine clearing and tonifying methods to control fire-toxin. After the PMN has formed, pathogenic toxin may flow along the collaterals, tending to lodge in corresponding viscera with functional imbalance and deviation between deficiency and excess, eventually giving rise to malignant tumors. Understanding the pathogenesis of the PMN in the malignant tumors based on the "toxin accumulation damaging
yin
" theory may provide a valuable perspective for developing traditional Chinese medicine strategies for the prevention and treatment of tumor metastasis.
关键词
Keywords
references
SATCHER RL , ZHANG XHF . Evolving cancer-niche interactions and therapeutic targets during bone metastasis [J]. Nat Rev Cancer , 2022 , 22 ( 2 ): 85 - 101 .
LIU Y , CAO X . Characteristics and significance of the pre-metastatic niche [J]. Cancer Cell , 2016 , 30 ( 5 ): 668 - 681 .
DE VISSER KE , JOYCE JA . The evolving tumor microenvironment: from cancer initiation to metastatic outgrowth [J]. Cancer Cell , 2023 , 41 ( 3 ): 374 - 403 .
JIANG Z , ZHOU J , LI L , et al . Pericytes in the tumor microenvironment [J]. Cancer Lett , 2023 , 556 : 216074 . doi: 10.1016/j.canlet.2023.216074 http://dx.doi.org/10.1016/j.canlet.2023.216074 .
MAO X , XU J , WANG W , et al . Crosstalk between cancer-associated fibroblasts and immune cells in the tumor microenvironment: new findings and future perspectives [J]. Mol Cancer , 2021 , 20 ( 1 ): 131 .
CHAKRABORTY C , SHARMA AR , SHARMA G , et al . The interplay among miRNAs, major cytokines, and cancer-related inflammation [J]. Mol Ther Nucleic Acids , 2020 , 20 : 606 - 620 . doi: 10.1016/j.omtn.2020. 04. 002 http://dx.doi.org/10.1016/j.omtn.2020.04.002 .
QIAN S , GOLUBNITSCHAJA O , ZHAN X . Chronic inflammation: key player and biomarker-set to predict and prevent cancer development and progression based on individualized patient profiles [J]. EPMA J , 2019 , 10 ( 4 ): 365 - 381 .
PEREIRA-VEIGA T , SCHNEEGANS S , ANTEL K , et al . Circulating tumor cell-blood cell crosstalk: biology and clinical relevance [J]. Cell Rep , 2022 , 40 ( 9 ): 111298 .
SOSA MS , BRAGADO P , AGUIRRE-GHISO JA . Mechanisms of disseminated cancer cell dormancy: an awakening field [J]. Nat Rev Cancer , 2014 , 14 ( 9 ): 611 - 622 .
RIIHIMAKI M , HEMMINKI A , SUNDQUIST J , et al . Patterns of metastasis in colon and rectal cancer [J]. Sci Rep , 2016 , 6 : 29765 . doi: 10.1038/srep29765 http://dx.doi.org/10.1038/srep29765 .
XU F , CUI W Q , WEI Y , et al . Astragaloside Ⅳ inhi-bits lung cancer progression and metastasis by modulating macrophage polarization through AMPK signaling [J]. JECCR , 2018 , 37 ( 1 ): 207 .
HAO HB , ZHANG Q , ZHU H , et al . Icaritin promotes tumor T-cell infiltration and induces antitumor immunity in mice [J]. Eur J Immunol , 2019 , 49 ( 12 ) : 2235 - 2244 .
SHI Z , SONG T , WAN Y , et al . A systematic review and meta-analysis of traditional insect Chinese medicines combined chemotherapy for non-surgical hepatocellular carcinoma therapy [J]. Sci Rep , 2017 , 7 ( 1 ): 4355 .
SHOU LM , ZHANG QY , LI W , et al . Cantharidin and norcantharidin inhibit the ability of MCF-7 cells to adhere to platelets via protein kinase C pathway-dependent downregulation of α2 integrin [J]. Oncol Rep , 2013 , 30 ( 3 ): 1059 - 1066 .
Pathogenesis and Prevention Strategies of Hypercoagulable State in Malignant Tumors Based on the Theory of "Sweet-Flavored Medicinals Retaining and Restoring Body Fluid"
Analysis of the Distribution of Traditional Chinese Medicine Syndrome Elements and Influencing Factors in Patients with Immune-Related Adverse Events from Malignant Tumors: A Retrospective Study Based on Propensity Score Matching
Current Status and Optimization Strategies for Investigator Initiated Trial on Traditional Chinese Medicine in the Treatment of Malignant Tumors Conducted by Western Medicine Institutions
Discuss the Preventive and Treatment for Immune-Related Adverse Events of Malignant Tumors Based on Simultaneous Treatment of Qi and Fire
Clinical Characteristics and Use of Traditional Chinese Medicine Therapy in 222 Malignant Tumor Cases with COVID-19: A Retrospective Study
Related Author
LIU Zhaidong
QIN Ruyu
SHI Yunxuan
SUN Yuwei
KONG Weiyang
CHENG Zixuan
WANG Yong
ZHUO Zhili
Related Institution
The Affiliated Hospital of Shandong University of Traditional Chinese Medicine
First Clinical Medical College,Shandong University of Traditional Chinese Medicine
Guang'anmen Hospital,China Academy of Chinese Medical Sciences
Beijing University of Chinese Medicine
Chinese Evidence-based Medicine Center,West China Hospital,Sichuan University