肝细胞癌（肝癌）免疫微环境主要由肿瘤相关巨噬细胞，髓源性抑制细胞等细胞成分，以及细胞因子、生长因子、细胞外基质等细胞外成分组成。我国大多数肝癌都合并慢性乙型病毒性肝炎及肝硬化，其免疫微环境促进肝癌的发生进展、免疫逃逸和治疗耐药，且具有免疫抑制作用。近年来，免疫检查点抑制剂（ICIs）等免疫疗法在肝癌的全身治疗方面取得了很大进展。然而，在KEYNOTE-240和CheckMate 459试验中，以纳武利尤单抗或帕博利珠单抗为单药的抗PD-1治疗未能达到预设的总生存终点。目前迫切需要更加深入了解HCC免疫微环境，并探索新的疗法来提高ICIs的疗效。当前，ICIs与其他疗法（如酪氨酸激酶抑制剂、单克隆抗体或局部治疗）的联合治疗已被证明可提高ICIs单药的有效率。本文就HCC免疫微环境、免疫治疗及免疫联合靶向治疗的研究进展进行综述。

The immune microenvironment of hepatocellular carcinoma (HCC) is mainly composed of tumor-associated macrophages, myeloid-derived suppressor cells and other cellular components, as well as extracellular components, such as cytokines, growth factors and extracellular matrix, etc. In China, most liver cancer patients are complicated with chronic hepatitis B and cirrhosis. Immune microenvironment promotes the incidence and progression of HCC, immune escape and treatment resistance, and exerts immunosuppressive effect. In recent years, significant progress has been made in immunotherapy for systemic treatment of HCC, such as immune checkpoint inhibitors (ICIs). However, in the KEYNOTE-240 and CheckMate 459 trials, anti-PD-1 therapy with nivolumab or pembrolizumab as a single drug failed to reach the expected overall survival endpoint. At present, it is urgent to deepen the understanding of immune microenvironment of HCC and explore novel therapies to improve clinical efficacy of ICIs. Currently, the combination of ICIs with other therapies (such as tyrosine kinase inhibitors, monoclonal antibodies or local therapy) has been proven to improve the efficiency of single ICIs. In this article, research progress in immune microenvironment, immunotherapy and immune combined with targeted therapy for HCC was reviewed.