160、超越肿瘤分型:元律医学癌症代谢—免疫状态的跨尺度计算与精准评估(Beyond Tumor Classification: Multiscale Computation of Metabolic–Immune States and Precision Assessment in Prim-Lex Oncology)

Systemic cancer assessment faces a structural methodological gap: genomics, metabolomics, spatial omics, chronobiology, and immune-informatics have each accumulated substantial evidence, yet this evidence remains dispersed across incompatible measurement languages, temporal scales, and levels of evidence, and has not been organized into an operationalizable, externally testable, and falsifiable clinical information structure. Meanwhile, the prevailing prognostic architecture centered on TNM staging and molecular subtyping, while clinically indispensable, follows an “anatomic–molecular” organizing logic that is insufficient to accommodate tumor metabolic state, microenvironmental spatial heterogeneity, host circadian coordination, and immune coherence—dimensions several of which have already shown statistical associations with treatment response or disease progression in independent studies. This paper develops a Prim-Lex Multimodal Clinical Framework for Cancer. The framework uses the Fivefold Prim-Fire as a cross-scale taxonomy of research objects, Five-Element computation as the organizing language for functional modules, Eight-Dimensional States as the clinical information description layer, and Nine-Nexus Guidance as a research-oriented decision-support layer. The core contribution is threefold. First, boundary specification: “Prim-Fire,” “coherence,” and “decoherence” are operationalized as statistical constructs or theoretical background; only the animal life Prim-Fire level is identified as directly relevant to clinical cancer questions; prior claims of “irreversible phase transition,” “NAD(H)/NAD⁺ imbalance as initiating root cause,” and “health coherence ≥ 0.85 as equivalent to no cancer” are explicitly abandoned as exceeding available evidence; thresholds not calibrated in independent cancer cohorts are presented as exploratory parameters only. Second, graded evidence mapping: a four-tier grading system (E1–E4) distinguishes human cancer evidence supported by guidelines or high-quality systematic reviews, observational candidate associations, indirect evidence from human non-cancer disease or mechanistic studies, and hypotheses derived solely from animal/in vitro or theoretical reasoning. Third, a pre-specified falsifiable validation protocol: H1 (incremental predictive value) is the primary test, specifying whether Eight-Dimensional indices provide reproducible, calibrated, and clinically net-beneficial predictive information beyond TNM staging, molecular subtyping, age, cancer type, treatment regimen, and baseline functional status; falsification conditions are pre-specified and cannot be circumvented by changing outcomes, subgroups, or thresholds. The anticipated contribution is not a new cancer therapy, nor a claim that Prim-Lex Theory has uncovered the “root mechanism” of cancer. Its value lies in providing an operationalizable, falsifiable, and methodologically auditable theory–measurement–validation loop for the multi-system assessment of cancer, enabling independent replication, testing, or refutation by medical oncology, radiation oncology, surgical oncology, pathology, and clinical prediction model communities.