恶性肿瘤作为我国首要致死病因，其发生与发展涉及遗传突变、信号通路异常活化及肿瘤微环境失调等多种机制，现有临床治疗仍面临化疗耐药与靶向治疗效果有限等挑战。芦荟大黄素（aloe-emodin，AE）作为传统中药芦荟中的主要蒽醌类活性成分，在抗肿瘤研究中展现出多靶点、多机制的潜在优势。综述AE抗肿瘤分子机制及相关研究进展，系统梳理了AE通过抑制蛋白激酶B/哺乳动物雷帕霉素靶蛋白通路促进肿瘤细胞自噬、激活线粒体通路诱导肿瘤细胞凋亡、下调基质金属蛋白酶表达、抑制肿瘤细胞侵袭与转移等实现抗肿瘤效应，以及通过调控免疫微环境增强抗肿瘤活性；并基于AE结构优化及药物联用策略，验证其在抗肿瘤中的治疗潜力。展望AE临床应用前景，以期为肿瘤治疗提供理论依据，并为新型治疗策略的开发提供参考。

Malignant tumors remain the leading cause of death in China. Their pathogenesis and progression involve multifaceted mechanisms, including genetic mutations, aberrant activation of signaling pathways, and dysregulation of the tumor microenvironment. Current clinical management continues to face significant challenges, such as chemotherapy resistance and the limited efficacy of targeted therapies. Aloe-emodin (AE), a primary anthraquinone active constituent found in the traditional medicinal plant Aloe, demonstrates a promising multi-targeted and multi-mechanistic profile as an anti-tumor agent. This review systematically elucidates the antitumor mechanisms and related research progress of AE, specifically highlighting the induction of autophagy via inhibition of the protein kinase B (Akt)/mammalian target of rapamycin (mTOR) axis, the promotion of apoptosis through activation of mitochondrial pathways, the suppression of invasion and metastasis by downregulating matrix metalloproteinases (MMPs), and the enhancement of antitumor activity via modulation of the tumor immune microenvironment. Additionally, AE enhances antitumor activity by modulating the immune microenvironment. Furthermore, the therapeutic potential of AE is validated through structural optimization and drug combination strategies. This review highlights recent advances in understanding the molecular mechanisms of AE and anticipates its clinical translation, aiming to provide a theoretical basis for cancer therapy and inform the development of novel treatment modalities.

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国家自然科学基金项目（82460801，82460857）；江西中医药大学校级科技创新团队发展计划项目（CXTD22007）；江西中医药大学省级大学生创新创业计划（S202510412084）