通讯作者: 李琳霈, lilinpei2008@163.com

DOI：10.12201/bmr.202609.00027

Treatment Based on Syndrome Differentiation of the Pre-metastatic Niche in Breast Cancer Liver Metastasis from the Perspective of “Liver is Yin in Form and Yang in Function

• 摘要：乳腺癌肝转移是乳腺癌远处转移的重要类型，其发生与转移前生态位（pre-metastatic niche, PMN）的形成密切相关。PMN的建立涉及炎症放大、免疫抑制、血管屏障破坏、细胞外基质重塑及代谢重编程等过程，为循环肿瘤细胞在肝脏定植提供条件。叶天士“肝体阴用阳”理论强调肝脏阴血濡养与阳气疏泄的相互依存关系，可为乳腺癌肝转移前生态位的病机认识提供理论依据。基于该理论，结合现代研究，乳腺癌肝转移前生态位的病机可从肝体不足、肝用郁滞及体用俱损三个层面加以认识：肝体不足重在防御功能下降，为PMN的形成提供易感条件；肝用郁滞重在结构重塑，推动细胞外基质沉积与血管屏障破坏；体用俱损则表现为炎症-免疫-代谢的多维协同失调。并据此确立治则：养肝体以固其本，调肝用以通其滞，扶正祛邪以挽其损，可为乳腺癌肝转移前生态位的中医辨治提供理论依据。

  关键词： 乳腺癌肝转移；转移前生态位；免疫抑制；代谢重编程；肝体阴用阳; ; ; ; 

   

  Abstract: Liver metastasis of breast cancer is an important type of distant metastasis of breast cancer, which is closely related to the formation of pre-metastatic niche (PMN). The establishment of PMN involves inflammatory amplification, immunosuppression, vascular barrier damage, extracellular matrix remodeling and metabolic reprogramming, which provides conditions for the colonization of circulating tumor cells in the liver. Ye Tianshi’s theory of “Liver Is Yin In Form And Yang In Function” emphasizes the interdependence between liver yin and blood nourishment and yang qi free flow, which can provide a theoretical basis for the understanding of the pathogenesis of the hepatic pre-metastatic niche in breast cancer liver metastasis. Based on this theory, and combined with modern research, The pathogenesis of pre-hepatic niche of breast cancer liver metastasis can be understood from three aspects : liver body deficiency, liver stagnation and body and concurrent impairment of both substance and function. Liver body deficiency focuses on the decline of defense function, which provides susceptible conditions for the formation of PMN. Liver stagnation focuses on structural remodeling, promoting extracellular matrix deposition and vascular barrier damage ; the impairment of both body and function is manifested as a multi-dimensional synergistic disorder of inflammation-immunity-metabolism. Based on this, the therapeutic principle is established : nourishing the liver body to consolidate its foundation, regulating liver to dredge its stagnation, and reinforcing healthy qi and eliminating pathogens to rescue the impairment, which can provide a theoretical basis for the TCM syndrome differentiation and treatment of the niche before liver metastasis of breast cancer.

  Key words: Liver metastasis of breast cancer; Pre-Metastatic Niche; Immunosuppression; Metabolic Reprogramming; Liver Is Yin In Form And Yang In Function

  提交时间：2026-09-18

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-08-15	10.12201/bmr.202609.00027V1	下载

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