肝细胞癌（HCC）是最常见的肝脏肿瘤类型，是癌症相关死亡的主要原因，并且肝癌的发病率在全球范围内仍在增加。治愈性肝切除术或肝移植仅适用于少数早期 HCC 患者。然而，大多数HCC患者由于疾病进展而不适合根治性切除，因此选择传统酪氨酸激酶抑制剂药物索拉非尼作为一线治疗。在过去的几年里，免疫疗法，主要是免疫检查点抑制剂（ICIs），彻底改变了HCC的临床策略。事实证明，与 ICI 的联合治疗比索拉非尼更有效，并且已经进行了临床试验以将这些疗法应用于患者。尽管免疫疗法取得了重大进展，但其背后的分子机制仍不清楚，而且免疫抵抗往往难以克服。多项研究指出HCC免疫微环境中复杂的细胞间通讯网络调节肿瘤逃逸和对免疫反应的耐药性。这强调了分析 HCC 免疫微环境的迫切需要。本综述介绍了肝癌免疫微环境中的免疫抑制细胞群，以及相关的临床试验，旨在为下一代精准免疫治疗提供见解。© 2024，Fu，Guo et al.

Hepatocellular carcinoma (HCC), the most common type of liver tumor, is a leading cause of cancer-related deaths, and the incidence of liver cancer is still increasing worldwide. Curative hepatectomy or liver transplantation is only indicated for a small population of patients with early-stage HCC. However, most patients with HCC are not candidates for radical resection due to disease progression, leading to the choice of the conventional tyrosine kinase inhibitor drug sorafenib as first-line treatment. In the past few years, immunotherapy, mainly immune checkpoint inhibitors (ICIs), has revolutionized the clinical strategy for HCC. Combination therapy with ICIs has proven more effective than sorafenib, and clinical trials have been conducted to apply these therapies to patients. Despite significant progress in immunotherapy, the molecular mechanisms behind it remain unclear, and immune resistance is often challenging to overcome. Several studies have pointed out that the complex intercellular communication network in the immune microenvironment of HCC regulates tumor escape and drug resistance to immune response. This underscores the urgent need to analyze the immune microenvironment of HCC. This review describes the immunosuppressive cell populations in the immune microenvironment of HCC, as well as the related clinical trials, aiming to provide insights for the next generation of precision immunotherapy.© 2024, Fu, Guo et al.