池久庆,马志军

乳腺癌免疫微环境（Tumor Immune Microenvironment，TIME）作为调控肿瘤发生发展及免疫治疗响应的关键因素，近年来引起广泛关注。TIME由多种免疫细胞及非细胞成分构成，其复杂的相互作用和空间异质性对肿瘤免疫逃逸和治疗效果产生重要影响。当前研究深入揭示了基因和表观遗传机制如何调控TIME的动态变化，推动了免疫微环境重塑策略的发展。ICI等免疫治疗手段在乳腺癌中的应用显示出显著疗效，联合治疗策略进一步提升了治疗潜力。然而，乳腺癌TIME的异质性和治疗耐受性仍是临床面临的重要挑战。本文系统综述了乳腺癌TIME的组成特点、调控机制及关键靶点，结合最新的临床应用进展，展望了未来技术创新与精准免疫治疗的发展方向，旨在为乳腺癌免疫治疗的个体化和有效性提供理论基础和实践指导。

乳腺癌；免疫微环境；免疫治疗；基因调控；免疫检查点；联合治疗；空间异质性

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