肿瘤微环境 (TME) 蕴藏着一个隐藏的相互作用领域，深刻影响着头颈癌 (HNC) 的行为。 HNC 不仅仅是局部问题；它们构成了影响数百万人的紧迫的全球健康危机，由于晚期诊断和对传统疗法的内在抵抗，常常导致严重的预后。在这种错综复杂的相互作用中，癌细胞充当战略参与者，熟练地操纵其微环境以促进增殖、逃避免疫检测并承受治疗干预。这种动态游戏的核心是外泌体，它是细胞通信的神秘棋子，全面携带重要信息。这篇综述阐明了外泌体在 TME 中的多方面作用，强调了它们传递关键信号的能力，这些信号不仅促进肿瘤进展，而且调节免疫反应，最终在 HNC 的演变中发挥关键作用。我们的见解旨在促进外泌体靶向疗法的进一步研究和探索，有可能改变 HNC 治疗的格局，并改善这场与癌症的艰苦斗争中的临床结果。版权所有 © 2024。由 Elsevier B.V. 出版。

The tumor microenvironment (TME) harbors a hidden universe of interactions that profoundly shape the behavior of head and neck cancers (HNCs). HNCs are not merely localized afflictions; they constitute a pressing global health crisis that impacts millions, frequently resulting in severe prognoses due to late-stage diagnosis and intrinsic resistance to conventional therapies. In this intricate interplay, cancer cells function as strategic players, adeptly manipulating their microenvironment to foster proliferation, evade immune detection, and withstand therapeutic interventions. Central to this dynamic play are exosomes, the enigmatic pawns of cellular communication, carrying vital messages across the board. This review elucidates the multifaceted roles of exosomes within the TME, highlighting their capacity to transmit critical signals that not only promote tumor progression but also modulate immune responses, ultimately playing a crucial role in the evolving narrative of HNC. Our insights aim to catalyze further research and exploration into exosome-targeted therapies, potentially transforming the landscape of HNC treatment and improving clinical outcomes in this formidable battle against cancer.Copyright © 2024. Published by Elsevier B.V.