缺氧作为肿瘤微环境的一个突出特征，对该环境内的多组分变化有着深远的影响。在缺氧条件下，肿瘤细胞的恶性表型、肿瘤微环境内的多种细胞类型以及细胞间的通讯和物质交换都会发生复杂的变化。这些变化为探索不同微环境条件下肿瘤发展机制和制定治疗策略提供了重要前景。肿瘤细胞和基质细胞分泌的外泌体是肿瘤微环境的组成部分，作为细胞间通讯和物质交换的重要介质，因此越来越受到研究人员的关注。本综述重点关注缺氧条件促进肿瘤细胞释放外泌体并改变其封装内容的机制。它还检查了缺氧条件下源自肿瘤细胞、免疫细胞和其他细胞类型的外泌体对肿瘤微环境的影响。此外，我们总结了目前外泌体在低氧条件下潜在临床应用的研究进展，并提出了该领域未来的研究方向。© 2024 Wang et al.

Hypoxia, as a prominent feature of the tumor microenvironment, has a profound impact on the multicomponent changes within this environment. Under hypoxic conditions, the malignant phenotype of tumor cells, the variety of cell types within the tumor microenvironment, as well as intercellular communication and material exchange, undergo complex alterations. These changes provide significant prospects for exploring the mechanisms of tumor development under different microenvironmental conditions and for devising therapeutic strategies. Exosomes secreted by tumor cells and stromal cells are integral components of the tumor microenvironment, serving as crucial mediators of intercellular communication and material exchange, and have consequently garnered increasing attention from researchers. This review focuses on the mechanisms by which hypoxic conditions promote the release of exosomes by tumor cells and alter their encapsulated contents. It also examines the effects of exosomes derived from tumor cells, immune cells, and other cell types under hypoxic conditions on the tumor microenvironment. Additionally, we summarize current research progress on the potential clinical applications of exosomes under hypoxic conditions and propose future research directions in this field.© 2024 Wang et al.