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EcoPathology銅蟲(chóng) (小有名氣)
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「中華醫(yī)學(xué)會(huì)成立110周年專欄」重新思考腫瘤
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【中華醫(yī)學(xué)會(huì)成立110周年專欄】“重新思考腫瘤” 正式發(fā)表,中國(guó)科學(xué)報(bào)/科學(xué)網(wǎng)刊文報(bào)道“后基因組時(shí)代,如何認(rèn)識(shí)腫瘤?”,歡迎廣大讀者閱讀與下載。 文章鏈接 https://rs.yiigle.com/cmaid/1542702 摘要 在過(guò)去半個(gè)世紀(jì)的全球抗癌斗爭(zhēng)中,無(wú)論是腫瘤基礎(chǔ)研究還是臨床實(shí)踐,幾乎所有探索均圍繞“體細(xì)胞突變”這一理論展開(kāi),比如在分子分型、個(gè)體化精準(zhǔn)醫(yī)學(xué)、基因治療、新抗原腫瘤疫苗研發(fā)以及測(cè)序技術(shù)開(kāi)發(fā)等諸多方面。即便近年備受矚目的腫瘤微環(huán)境研究,包括腫瘤免疫方向,其最終歸因仍往往指向癌細(xì)胞或微環(huán)境細(xì)胞中的某些特定基因和突變。然而,“體細(xì)胞突變”范式并未為臨床帶來(lái)真正有效的腫瘤治愈路徑,倘若繼續(xù)以該理論為主導(dǎo)框架,顯然難以在腫瘤的理解與治療上取得實(shí)質(zhì)性進(jìn)步。因此,在腫瘤研究史的這個(gè)關(guān)鍵十字路口,一場(chǎng)徹底的新思維變革迫在眉睫。文章闡述了腫瘤系統(tǒng)為理解腫瘤本質(zhì)所帶來(lái)的新視角,腫瘤生態(tài)學(xué)的基本原理及其在治療中的潛在應(yīng)用,并探討了生態(tài)病理學(xué)這一新興領(lǐng)域的理論框架與研究意義。呼吁要摒棄當(dāng)前主導(dǎo)的腫瘤線性還原舊范式,更重要的是,致力于為后基因組時(shí)代的新腫瘤學(xué)和腫瘤生態(tài)哲學(xué)搭建一個(gè)切實(shí)可行且系統(tǒng)化的認(rèn)知框架,以推動(dòng)攻克惡性腫瘤這一社會(huì)目標(biāo)。 ABSTRACT Over the past half-century of the global effort against cancer, the vast majority of investigations in both tumor basic research and clinical practice have centered on the "somatic mutation" theory, such as in molecular classification, individualized precision medicine strategies, gene therapy approaches, the development of neoantigen-based tumor vaccines, and advancements in sequencing technologies. Even in the extensively studied tumor microenvironment (including tumor immunity), which has garnered significant attention in recent years, the underlying mechanisms frequently revert to specific genes and mutations within tumor cells or microenvironmental cells as the primary driving forces. However, despite the dominance of the "somatic mutation" paradigm, truly effective approaches for curing cancer in clinical settings remain elusive. Undoubtedly, if the prevailing "somatic mutation theory" continues to monopolize cancer research, meaningful progress in understanding and treating cancer will likely remain frustratingly out of reach. At this critical juncture in the evolution of cancer research, a comprehensive re-evaluation of cancer not only is necessary but also imperative, highlighting the urgent need for a profound transformation in our conceptual framework. This article systematically elucidates the novel perspective offered by the "tumor system" for comprehending the essence of cancer, the foundational principles of "tumor ecology" and their potential applications in treatment, and explores in depth the theoretical framework and research significance of the emerging field of "ecological pathology". Beyond merely advocating for the abandonment of the currently dominant linear reductionist paradigm of cancer, this commentary strives to construct a pragmatic and systematically structured framework to guide the trajectory of the "post-genomic revolution in oncology" and the "tumor ecological philosophy", ultimately fostering the realization of the overarching societal goal of eradicating cancer. |
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