癌症干细胞（CSC）在肿瘤内只占很小的细胞比例（<1%），由于其固有的自我更新、多谱系分化能力，对肿瘤的发生、转移、复发和治疗耐药具有深远的影响和肿瘤启动潜力。近年来，越来越多的研究表明，CSC 和肿瘤免疫微环境在驱动肿瘤进展和降低癌症治疗功效方面相互作用。细胞外囊泡 (EV) 是细胞间通讯的关键介质，在 CSC 和免疫细胞之间建立了不可或缺的生物联系。通过转移蛋白质、核酸和脂质等生物活性分子，EV可以对CSC和免疫细胞产生相互影响。这种相互作用在重塑肿瘤免疫微环境、为CSC的维持和增殖创造有利条件方面发挥着重要作用。破译 CSC 和免疫细胞之间复杂的相互作用将为了解 CSC 更容易免疫逃逸的机制提供有价值的见解。本综述将重点介绍肿瘤微环境中 CSC 与每个免疫细胞谱系之间 EV 介导的通讯，并探索潜在的治疗机会。版权所有 © 2024 Li、Zhang、Yue 和 Jiang。

Cancer stem cells (CSCs), accounting for only a minor cell proportion (< 1%) within tumors, have profound implications in tumor initiation, metastasis, recurrence, and treatment resistance due to their inherent ability of self-renewal, multi-lineage differentiation, and tumor-initiating potential. In recent years, accumulating studies indicate that CSCs and tumor immune microenvironment act reciprocally in driving tumor progression and diminishing the efficacy of cancer therapies. Extracellular vesicles (EVs), pivotal mediators of intercellular communications, build indispensable biological connections between CSCs and immune cells. By transferring bioactive molecules, including proteins, nucleic acids, and lipids, EVs can exert mutual influence on both CSCs and immune cells. This interaction plays a significant role in reshaping the tumor immune microenvironment, creating conditions favorable for the sustenance and propagation of CSCs. Deciphering the intricate interplay between CSCs and immune cells would provide valuable insights into the mechanisms of CSCs being more susceptible to immune escape. This review will highlight the EV-mediated communications between CSCs and each immune cell lineage in the tumor microenvironment and explore potential therapeutic opportunities.Copyright © 2024 Li, Zhang, Yue and Jiang.