Head and neck squamous cell carcinoma (HNSCC) is a highly aggressive malignancy characterized by complex interactions within the tumor microenvironment (TME) that facilitate immune evasion and tumor progression. The TME consists of diverse cellular components, including cancer-associated fibroblasts, immune and endothelial cells, and extracellular matrix elements, that collectively modulate tumor growth, metastasis, and resistance to therapy. Immune evasion in HNSCC is orchestrated through multiple mechanisms, including the suppression of cytotoxic T lymphocytes, recruitment of immunosuppressive cells, such as regulatory T and myeloid-derived suppressor cells, and upregulation of immune checkpoint molecules (e.g., PD-1/PD-L1 and CTLA-4). Natural killer (NK) cells, which play a crucial role in anti-tumor immunity, are often dysfunctional within the HNSCC TME due to inhibitory signaling and metabolic constraints. Additionally, endothelial cells contribute to tumor angiogenesis and immune suppression, further exacerbating disease progression. Recent advancements in immunotherapy, particularly immune checkpoint inhibitors and NK cell-based strategies, have shown promise in restoring anti-tumor immunity. Moreover,TP53mutations, frequently observed in HNSCC, influence tumor behavior and therapeutic responses, highlighting the need for personalized treatment approaches. This review provides a comprehensive analysis of the molecular and cellular mechanisms governing immune evasion in HNSCC with a focus on novel therapeutic strategies aimed at improving patient outcomes.
头颈部鳞状细胞癌（HNSCC）是一种高度侵袭性的恶性肿瘤，其肿瘤微环境（TME）内复杂的相互作用促进了免疫逃逸和肿瘤进展。TME由多种细胞成分组成，包括癌症相关成纤维细胞、免疫细胞、内皮细胞以及细胞外基质，这些成分共同调控肿瘤生长、转移和治疗抵抗。HNSCC的免疫逃逸通过多种机制协调实现，包括抑制细胞毒性T淋巴细胞、招募免疫抑制细胞（如调节性T细胞和髓源性抑制细胞）以及上调免疫检查点分子（如PD-1/PD-L1和CTLA-4）。自然杀伤（NK）细胞在抗肿瘤免疫中起关键作用，但在HNSCC的TME中常因抑制性信号和代谢限制而功能失调。此外，内皮细胞促进肿瘤血管生成和免疫抑制，进一步加剧疾病进展。近年来免疫治疗领域的进展，特别是免疫检查点抑制剂和基于NK细胞的策略，在恢复抗肿瘤免疫方面显示出潜力。同时，HNSCC中常见的TP53突变会影响肿瘤行为和治疗反应，凸显了个体化治疗策略的必要性。本综述全面分析了HNSCC免疫逃逸的分子与细胞机制，并重点探讨旨在改善患者预后的新型治疗策略。
肿瘤(癌症)患者之家