作者：朱金霞1，刘光伟2，杨培伟2

单位：1.河南中医药大学, 河南 郑州 450000; 2.河南中医药大学第一附属医院 脾胃肝胆科, 河南 郑州 450000

Authors: Zhu Jinxia1，Liu Guangwei2，Yang Peiwei2

Unit: 1.Henan University of Traditional Chinese Medicine，Zhengzhou 450000, Henan, China; 2.Department of Hepatology and Spleen -Stomach, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine，Zhengzhou 450000, Henan, China

摘要：

肝细胞癌（HCC）有高发病率、高转移率、低生存率、治疗效果差等特点。转移前生态位是指远处器官发生必要的变化以创造适合肿瘤细胞定植的局部微环境。外泌体是具有多种生物学功能的细胞外囊泡，在转移前生态位的形成中起重要作用。本文总结了外泌体对转移前生态位的影响，包括在HCC转移前生态位中介导特异性器官转移、增加血管生成和血管通透性、促进基质细胞活化和细胞外基质重塑、诱导HCC免疫抑制和免疫监视、为HCC靶向治疗提供新依据等；指出了利用外泌体在HCC转移前生态位中的作用，筛选出能预测肿瘤转移、预后及治疗效果的生物标志物，对延缓HCC病情进展有潜在的临床意义。

关键词：外泌体； 肝细胞癌； 转移前生态位； 肿瘤微环境； 免疫调节

Abstract：

The characteristics of hepatocellular carcinoma （HCC）is high incidence, high metastasis rate, low survival rate, and poor treatment effect. Pre -metastasis niche refers to the necessary changes in distant organs to create a local microenvironment suitable for tumor cell colonization. Exosomes are extracellular vesicles with multiple biological functions and play an important role in the formation of the pre-metastasis niche. This article summarizes the effects of exosomes on the pre-metastasis niche, including mediating specific organ metastasis in the pre -metastasis niche of HCC, increasing angiogenesis and vascular permeability, promoting stromal cell activation and extracellular matrix remodeling, and inducing HCC immunosuppression or immune surveillance, provide new basis for HCC targeted therapy, etc. It is pointed out that the use of exosomes in the pre-metastasis niche of HCC to screen out biomarkers that can predict tumor metastasis, prognosis and therapeutic effects has potential clinical significance for delaying the progression of HCC.

Key Words:  Exosomes; Hepatocellular carcinoma; Pre-transfer niche; Tumor microenvironment; Immune regulation