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This supports a direct interaction, although their underlying mechanisms are still in the early stages of investigation and further studies with larger sample sizes or validation are required (Wang Q

2 Mechanisms of hypoxia in the tumor microenvironment 2.1 Development of hypoxia in tumors Hypoxia is a common feature observed in approximately 90% of solid tumors and is widely recognized as a hallmark of cancer ( Figure 3 ) ( Figure 3 Hypoxia in tumors can be broadly categorized into two distinct forms: chronic hypoxia and acute (or cycling) hypoxia ( In contrast, acute hypoxia, also referred to as cycling or intermittent hypoxia, arises due to transient fluctuations in tumor blood flow ((no longer than 24 h))., leading to to oxygen levels below 1% that can be reversed with returned blood flow ( Both chronic and acute hypoxia coexist within tumors and play critical, yet distinct, roles in shaping the tumor biology