Immune-based therapies such as immune checkpoint inhibitors have revolutionized the systemic treatment of various cancer types. The therapeutic application of monoclonal antibodies targeting inhibitory pathways such as programmed cell death-1(PD-1)/programmed cell death ligand 1 (PD-L1) and CTLA-4 to cells of the adaptive immune system has recently been shown to generate meaningful improvement in the clinical outcome of hepatocellular carcinoma (HCC). Nevertheless, current immunotherapeutic approaches induce durable responses in only a subset of HCC patients. Since immunologic mechanisms such as chronic inflammation due to chronic viral hepatitis or alcoholic and nonalcoholic fatty liver disease play a crucial role in the initiation, development, and progression of HCC, it is important to understand the underlying mechanisms shaping the unique tumor microenvironment of liver cancer. The liver is an immunologic organ with large populations of innate and innate-like immune cells and is exposed to bacterial, viral, and fungal antigens through the gut–liver axis. Here, we summarize and highlight the role of these cells in liver cancer and propose strategies to therapeutically target them. We also discuss current immunotherapeutic strategies in HCC and outline recent advances in our understanding of how the therapeutic potential of these agents might be enhanced.

免疫检查点抑制剂等基于免疫的疗法已经彻底改变了各种癌症类型的全身治疗。靶向抑制途径的单克隆抗体，如程序性细胞死亡-1（PD-1）/程序性细胞死亡配体 1（PD-L1）和 CTLA-4 对适应性免疫系统细胞的治疗应用最近已被证明产生有意义的改善肝细胞癌（HCC）的临床结果。然而，目前的免疫治疗方法仅在一部分 HCC 患者中诱导持久反应。由于慢性病毒性肝炎或酒精性和非酒精性脂肪肝引起的慢性炎症等免疫机制在 HCC 的发生、发展和进展中起着至关重要的作用，了解塑造肝癌独特肿瘤微环境的潜在机制非常重要。肝脏是一个免疫器官，拥有大量先天性和先天性样免疫细胞，通过肠-肝轴暴露于细菌、病毒和真菌抗原。在这里，我们总结并强调了这些细胞在肝癌中的作用，并提出了针对它们的治疗策略。我们还讨论了 HCC 中当前的免疫治疗策略，并概述了我们对如何增强这些药物的治疗潜力的理解的最新进展。我们总结并强调了这些细胞在肝癌中的作用，并提出了针对它们的治疗策略。我们还讨论了 HCC 中当前的免疫治疗策略，并概述了我们对如何增强这些药物的治疗潜力的理解的最新进展。我们总结并强调了这些细胞在肝癌中的作用，并提出了针对它们的治疗策略。我们还讨论了 HCC 中当前的免疫治疗策略，并概述了我们对如何增强这些药物的治疗潜力的理解的最新进展。