Discussion on Formation and Intervention of the Tumor Microenvironment Based on the Theory of “Where There is Mass Hardness， There must be Latent Yang” / 中医杂志

ABSTRACT

As the environmental foundation for tumor survival，the tumor microenvironment is characterized by immunosuppression， ischemia and hypoxia， metabolic reprogramming， and inflammatory infiltration， providing conditions for tumor cell colonization， malignant transformation and migration. In traditional Chinese medicine （TCM）， yang qi is considered to be closely related to the onset of tumors. Based on the TCM theory of “where there is mass hardness， there must be latent yang”， this paper suggests that the state of “latent yang” formed by abnormal yang energy is highly similar to the tumor microenvironment. The loss of protection of latent yang leads to the weakening of positive immunity， invasion of disease and then accumulation of tumors. The constraint of latent yang leads to microcirculation disorders， blocked vessels and collaterals， and finally qi and blood blockage. The turbidity of latent yang leads to abnormal metabolic products gathering， pathogenic turbidity accumulation， and tumor formulation through contention and binding between them. The transformation of fire by latent yang mediates “inflammation-cancer” transformation， and leads to malignant transformation of cancerous tumors. The transformation of latent yang into toxin leads to premeditated pre-metastatic niches， healthy qi deficiency and toxin accumulation， and cancerous toxins flow. Based on the theory of “latent yang” and modern researches， this paper summarized the method of “warming yang and invigorating qi to consolidate the root， promoting yang and moving qi to eliminate stasis， strengthening yang capacity of transforming qi to remove the disadvantages， diffusing yang and opening up constraint to disperse fire， and reinforcing healthy qi and clearing the source to prevent toxins” in the intervention of the tumor microenvironment， so as to provide ideas for TCM to reshape the tumor microenvironment and regulate the tumor process.