Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.
Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, P.R. China.
Int J Mol Med. 2019 Feb;43(2):647-656. doi: 10.3892/ijmm.2018.4004. Epub 2018 Nov 28.
In the integrative theory, chronic irritations induce tumors with genetic alterations and rapid proliferative ability. Tumor cells reprogram the metabolism and employ aerobic glycolysis to sustain rapid growth. The host provides both the nutrients and exhaust system to support tumor growth via the tumor microenvironment. Under certain conditions, such as aging, diabetes, obesity and a high‑fat diet, the exhaust system is impaired, triggering a metabolic imbalance between the tumor and host. This is similar to a problematic car with an advanced motor with an out‑of‑date exhaust system. The metabolic imbalance causes a metabolic catastrophe, making tumor cells reside in a dismal environment and forcing them to invade, metastasize and undergo necrosis. Tumor necrosis, particularly in metastases, leads to non‑specific systemic inflammation, which is the major cause of cancer‑related mortality. On the whole, the integrative theory views cancer in an integrative manner and proposes that both genetic alterations and tumor‑host interaction as regards metabolism and immunology determine the destiny of the tumor and host. Although cancer is a genetic disease, tumor biology is basically the nature of the host.
在整合理论中，慢性刺激会导致具有遗传改变和快速增殖能力的肿瘤。肿瘤细胞重新编程代谢，通过有氧糖酵解来维持快速生长。宿主通过肿瘤微环境为肿瘤生长提供营养和废气系统。在某些情况下，如衰老、糖尿病、肥胖和高脂肪饮食，废气系统受损，导致肿瘤和宿主之间代谢失衡。这类似于一辆有先进发动机但排气系统过时的有问题的汽车。代谢失衡会导致代谢灾难，使肿瘤细胞处于恶劣的环境中，并迫使它们侵袭、转移和发生坏死。肿瘤坏死，特别是在转移中，会导致非特异性全身炎症，这是癌症相关死亡的主要原因。总的来说，整合理论以综合的方式看待癌症，并提出遗传改变和肿瘤-宿主之间关于代谢和免疫学的相互作用决定了肿瘤和宿主的命运。尽管癌症是一种遗传性疾病，但肿瘤生物学基本上是宿主的性质。
