肿瘤微环境和血管正常化在中西医结合治疗肿瘤中的作用机制探讨

Study on the Tumor Microenvironment and Tumor Vascular Normalization in Integrative Treatment of Tumor by Chinese Medicine and Western Medicine

肿瘤内部血管异常是造成肿瘤微环境异常的重要因素,而微环境不仅与肿瘤恶性程度转移复发密切相关,其所造成的酸性环境、乏氧等因素严重影响肿瘤的常规治疗及放化疗疗效。以血管内皮生长因子(vascular endothelial growth factor,VEGF)为目标靶点的抗肿瘤新生血管治疗药物不仅能拮抗肿瘤血管新生,而且能在一定程度上促进肿瘤内部血管正常化,从而降低细胞间质压,改善肿瘤内部血供,提高放化疗的疗效。既往的临床及基础研究已证实,许多中药在与放化疗联合的综合治疗中具有增敏增效作用,同时近年研究亦证明许多中药具有抗肿瘤血管新生并降低血清VEGF浓度、抑制VEGF表达作用。因此,从促肿瘤血管正常化角度探讨中医药抗肿瘤机制对寻找中医疗法在综合治疗中时间的切入点,优化治疗方案,并进一步阐明中医药在综合治疗中的作用开辟了一个全新的领域。

Vascular abnormalities inside tumors are important factors resulting in abnormal tumor microenvironment.Microenvironment was closely correlated with the malignant degrees,metastasis,and recurrence of tumors.Besides,the acid environment,oxygen deficiency,and other factors it induced may severely affect the efficacies of routine therapies,radiotherapy and chemotherapy.Anti-angiogenesis treatment drugs targeting vascular endothelial growth factor （VEGF） not only antagonize the angiogenesis of tumor vessels,but also promote the vascular normalization inside tumors to some extent,thus reducing interstitial hypertension,improving blood flow inside tumors,and enhancing therapeutic efficacies.Previous clinical and experimental studies have proved that many Chinese herbs show enhancing effects of chemotherapy and radiotherapy in comprehensive treatment of chemotherapy and radiotherapy combination.Meanwhile,recent studies have also proved that many Chinese herbs could fight against tumor vascular angiogenesis,lower serum VEGF concentration,and inhibit expressions of VEGF.Therefore,studying Chinese herbs＇ mechanisms of anti-tumor from promoting vascular normalization will open up a brand new field for seeking a cut-in point for Chinese medicine therapy in the comprehensive treatment,optimizing a treatment protocols,and further clarifying the roles of Chinese medicine in the comprehensive treatment.