肝细胞癌微环境研究进展及临床意义

Progress in the Study of Hepatocellular Carcinoma Microenvironment and Its Clinical Significance

摘要: 肝癌已成为全球最高发的癌症之一，在我国，它的死亡率高居第二位，在全球占据第四位。肝癌中肝细胞癌( Hepatocellular Carcinoma, HCC)占比最高。肝切除术被认为是HCC患者最佳的治疗选择，其重要性不容忽视。但此方法适用于早期肝脏肿瘤并且手术后复发率极高。我国肝癌诊断多为晚期无法直接进行手术治疗，因此HCC的预后非常差。近年来，肝癌的免疫治疗延长了患者的生命，由于新的治疗方法多是基于肝细胞癌肿瘤微环境(tumor microenvironment, TME)的，因此有必要阐明HCC的肿瘤微环境。在本综述中，我们总结阐述了HCC肿瘤微环境特征，HCC免疫微环境(tumour immune microenvironment, TIME)五个亚型及与预后的关系，HCC微环境免疫网络，当前针对免疫微环境的治疗以及临床常用HCC微环境指标。

Abstract: Hepatocellular carcinoma (HCC) is the most common subtype of liver cancer which ranks fourth in terms of global cancer mortality and second in terms of tumor-related mortality in our country. While surgical resection is the current preferred treatment for liver cancer, it is only suitable for early-stage liver tumors and has an extremely high recurrence rate. Diagnosis of liver cancer in our country is mostly at a late stage, making it difficult to receive direct surgical treatment, resulting in a very poor prognosis for HCC. In recent years, immunotherapy for liver cancer has extended the life of patients. Since new treatment methods are mostly based on the tumor microenvironment (TME) of hepatocellular carcinoma, it is necessary to clarify the TME of HCC. In this review, we summarize and elaborate on the TME characteristics of HCC, the five subtypes of the tumour immune microen-vironment (TIME) of HCC and their relationship with prognosis, the immune network of the HCC mi-croenvironment, and the current treatments targeting the immune microenvironment, as well as the commonly used HCC microenvironment indicators in clinical practice.