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恶性胸腔积液（malignant pleural effusion，MPE）可继发于多种晚期恶性肿瘤。尽管全身抗肿瘤治疗对原发肿瘤治疗有效，但仍有部分患者MPE控制不佳。肿瘤细胞、免疫细胞、间质细胞相互作用以及肿瘤相关血管异常增殖构建了MPE免疫抑制微环境，促进肿瘤细胞异常增殖和MPE的形成。随着对肿瘤微环境的深入研究，胸腔内局部应用免疫检查点抑制剂、免疫细胞及细胞因子和基因介导的细胞毒等免疫疗法可有效改善免疫抑制的肿瘤微环境，抑制MPE的形成。本文将阐述MPE的肿瘤微环境特征及相应的治疗新进展。

Malignant pleural effusion (MPE) can be secondary to various advanced malignant tumors. Although systemic anti tumor therapy may be effective in primary tumors, it cannot reduce the accumulation of MPE in proportion of the patients. The interaction of tumor cells, immune cells, and mesenchymal cells, as well as the abnormal proliferation of tumor-associated blood vessels, together create an immunosuppressive microenvironment for MPE, which promotes the abnormal proliferation of tumor cells and the accumulation of MPE. With the in-depth study of the tumor microenvironment, the application of local systemic anti-tumor therapy with local intrathoracic application of immune checkpoint inhibitors, immune cells, cytokines, and gene-mediated cytotoxic immunotherapy are able to alleviate the immunosuppressive tumor microenvironment and inhibit the accumulation of MPE. This article aimed to describe the tumor microenvironment in MPE and provide clues for identifying novel therapeutic targets.