本系统综述研究了 HBV 相关肝细胞癌 (HCC) 的免疫抑制环境，其特征是 HBV 特异性 T 细胞功能失调和耗尽，同时 HBV 特异性 CD4 T 细胞，特别是调节性 T 细胞 (Treg) 浸润增加。检查点抑制剂（尤其是 PD-1）表达的升高与疾病进展和复发有关，表明其作为预后指标和免疫治疗靶标的潜力。然而，使用 PD-1 抑制剂的效果有限。从未来的角度来看，了解先天性免疫反应和适应性免疫反应之间复杂的相互作用有望精确定位预测生物标志物并为 HBV 相关 HCC 制定新的治疗方法。

This systematic review investigates the immunosuppressive environment in HBV-associated hepatocellular carcinoma (HCC), characterized by dysfunctional and exhausted HBV-specific T cells alongside an increased infiltration of HBV-specific CD4+ T cells, particularly regulatory T cells (Tregs). Heightened expression of checkpoint inhibitors, notably PD-1, is linked with disease progression and recurrence, indicating its potential as both a prognostic indicator and a target for immunotherapy. Nevertheless, using PD-1 inhibitors has shown limited effectiveness. In a future perspective, understanding the intricate interplay between innate and adaptive immune responses holds promise for pinpointing predictive biomarkers and crafting novel treatment approaches for HBV-associated HCC.