基于肿瘤外泌体探讨中医药防治大肠癌肝转移机制

Mechanism of Traditional Chinese Medicine in the Prevention and Treatment of Colorectal Cancer Liver Metastasis Based on Tumor Exosomes

肝脏作为结直肠癌常见的远处转移靶器官,其发生转移受到人体自身免疫力和肿瘤微环境等多因素调控的影响。肝转移是结直肠癌晚期患者死亡的主要原因。外泌体是直径为30~150 nm的细胞外囊泡体,结直肠癌来源的外泌体含有的miRNA与癌基因参与肿瘤的复发、转移。中医认为结直肠癌肝转移(CRLM)的原因不外乎“正虚”与“邪实”。中医药具有整体性、多成分、多靶点的特点,可通过调节外泌体调控细胞间通信并影响肿瘤微环境,防治肿瘤的复发、转移。一方面通过“扶正健脾固本”提高患者免疫力,改善肿瘤抑制微环境;另一方面通过“调气祛瘀解毒”改善肿瘤炎症微环境,使癌毒无法存活。

As a common target organ for distant metastasis in colorectal cancer,metastasis to the liver is influenced by various factors such as the immune system of the body and the tumor microenvironment.Liver metastasis is a major cause of death in patients with advanced colorectal cancer.Exosomes are extracellular vesicles with a diameter of 30 to 150 nm.Exosomes derived from colorectal cancer contain miRNAs and oncogenes that participate in tumor recurrence and metastasis.Traditional Chinese medicine(TCM)believes that the causes of colorectal cancer liver metastasis(CRLM)are mainly related to“deficiency of vital qi”and“excess of pathogenic qi”.TCM features holistic treatment,multiple components,and multiple targets,which can regulate intercellular communication through exosomes and affect the tumor microenvironment to prevent tumor recurrence and metastasis.On one hand,by“strengthening the vital qi,invigorating the spleen,and consolidating the foundation”,TCM can enhance the patient′s immune system and improve the tumor-suppressive microenvironment.On the other hand,by“regulating qi,eliminating blood stasis,and removing toxin”,TCM can improve the tumor′s inflammatory microenvironment,making it inhospitable for cancerous growth.