Modes of tumor cell interaction include autocrine stimulation, secretion of paracrine growth factors and inhibitors, as well as interaction with the tumor macroenvironment. This evolving concept in tumor pathobiology describes the interaction of a malignant tumor with its host as an extension and addition to its local interaction with tumor cells and surrounding nontransformed cells, the tumor microenvironment. Angiogenesis, which is considered part of the tumor microenvironment, also allows reciprocal interactions between cancer cells and other organs and systems. Well-known examples of tumor endocrine signaling are the paraneoplastic syndromes. In addition, cachexia, a severe complication of tumor growth, results from the systemic reprogramming of the host metabolism as a result of tumor growth and progression. Moreover, recent reports indicate that cancer cells may secrete factors that might play a role in forming premetastatic niches at distant sites. In addition, cancer cells seem to be able to secrete factors influencing and resetting endogenous circadian organizers. The importance of understanding the whole complex interaction of a malignant tumor and its host – the tumor macroenvironment – is of great importance for the better management and treatment of cancer patients.

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肿瘤宏观环境：更新

肿瘤细胞相互作用的模式包括自分泌刺激、旁分泌生长因子和抑制剂的分泌，以及与肿瘤大环境的相互作用。肿瘤病理学中这一不断发展的概念将恶性肿瘤与其宿主的相互作用描述为它与肿瘤细胞和周围未转化细胞（肿瘤微环境）局部相互作用的延伸和补充。血管生成被认为是肿瘤微环境的一部分，它也允许癌细胞与其他器官和系统之间的相互作用。肿瘤内分泌信号的众所周知的例子是副肿瘤综合征。此外，恶病质是肿瘤生长的严重并发症，是肿瘤生长和进展导致宿主代谢系统性重编程的结果。而且，最近的报告表明，癌细胞可能会分泌一些因子，这些因子可能在远处部位形成转移前壁龛中发挥作用。此外，癌细胞似乎能够分泌影响和重置内源性昼夜节律组织者的因素。了解恶性肿瘤与其宿主（肿瘤大环境）之间复杂的相互作用对于更好地管理和治疗癌症患者具有重要意义。