几十年来，腹膜表面恶性肿瘤（PSM）一直与有限的治疗选择和不良的预后相关。然而，围手术期全身化疗、细胞减灭术（CRS）和腹腔热灌注化疗（HIPEC）的进步显着改善了临床结果。 PSM 主要由腹内肿瘤扩散引起，然后形成继发性腹膜转移。结直肠癌、卵巢癌和胃癌是最常见的原因。尽管主要起源不同，但腹膜微环境的独特性塑造了 PSM 的共同特征。腹膜转移涉及肿瘤细胞与腹膜微环境之间复杂的相互作用。成纤维细胞发挥着至关重要的作用，有助于肿瘤的发生、进展和治疗耐药。 PSM 中的腹膜转移相关成纤维细胞 (MAF) 表现出高度异质性。单细胞 RNA 测序技术表明，免疫调节癌症相关成纤维细胞 (iCAF) 似乎是 PSM 中最常见的亚型。此外，在 PSM 研究中也经常观察到其他主要亚型，如肌成纤维细胞 CAF (myCAF) 和基质 CAF (mCAF)。腹膜 MAF 被认为起源于间皮细胞、间皮下成纤维细胞、周细胞、内皮细胞和网膜驻留细胞。 CAF 的这种可塑性和异质性导致 PSM 中复杂的微环境，影响治疗反应。了解这些相互作用对于开发有针对性的局部疗法以改善 PSM 患者的治疗效果至关重要。© 2024。作者。

Over decades, peritoneal surface malignancies (PSMs) have been associated with limited treatment options and poor prognosis. However, advancements in perioperative systemic chemotherapy, cytoreductive surgery (CRS), and hyperthermic intraperitoneal chemotherapy (HIPEC) have significantly improved clinical outcomes. PSMs predominantly result from the spread of intra-abdominal neoplasia, which then form secondary peritoneal metastases. Colorectal, ovarian, and gastric cancers are the most common contributors. Despite diverse primary origins, the uniqueness of the peritoneum microenvironment shapes the common features of PSMs. Peritoneal metastization involves complex interactions between tumour cells and the peritoneal microenvironment. Fibroblasts play a crucial role, contributing to tumour development, progression, and therapy resistance. Peritoneal metastasis-associated fibroblasts (MAFs) in PSMs exhibit high heterogeneity. Single-cell RNA sequencing technology has revealed that immune-regulatory cancer-associated fibroblasts (iCAFs) seem to be the most prevalent subtype in PSMs. In addition, other major subtypes as myofibroblastic CAFs (myCAFs) and matrix CAFs (mCAFs) were frequently observed across PSMs studies. Peritoneal MAFs are suggested to originate from mesothelial cells, submesothelial fibroblasts, pericytes, endothelial cells, and omental-resident cells. This plasticity and heterogeneity of CAFs contribute to the complex microenvironment in PSMs, impacting treatment responses. Understanding these interactions is crucial for developing targeted and local therapies to improve PSMs patient outcomes.© 2024. The Author(s).