尽管进行了数十年激烈竞争的研究和巨额的财务投资，多数患有晚期实体肿瘤的患者无法接受治愈性治疗。为改善这种情况，迫切需要概念上新颖的治疗方法。癌症越来越被认为是一种全身性疾病，许多机体因素与肿瘤生长功能性相关，例如全身代谢紊乱、慢性炎症、肠道菌群紊乱和破坏的昼夜节律。可以想象，针对这些过程的干预可能对癌症患者有重大裨益。造成肿瘤支持性全身系统混乱的一项重要因素是过度消耗简单、高加工碳水化合物。这种饮食模式与高胰岛素血症、胰岛素抵抗、慢性炎症和肠道菌群紊乱有因果关联，着眼于相关问题——是否采用饮食限制碳水化合物对癌症患者有益。本综述总结了出版的研究数据，阐述了饮食限制碳水化合物在肝细胞癌（HCC，原发性肝癌最常见类型）发病机制中的作用。除了概述饮食、肠道菌群和免疫的功能相互作用外，本综述强调了胆汁酸在肠道微生物群落和免疫细胞之间的联系的重要性。版权所有© 2023 Elsevier Ltd。保留所有权利。

Despite decades of fiercely competitive research and colossal financial investments, the majority of patients with advanced solid cancers cannot be treated with curative intent. To improve this situation, conceptually novel treatment approaches are urgently needed. Cancer is increasingly appreciated as a systemic disease and numerous organismal factors are functionally linked to neoplastic growth, e.g. systemic metabolic dysregulation, chronic inflammation, intestinal dysbiosis and disrupted circadian rhythms. It is tempting to hypothesize that interventions targeting these processes could be of significant account for cancer patients. One important driver of tumor-supporting systemic derangements is inordinate consumption of simple and highly processed carbohydrates. This dietary pattern is causally linked to hyperinsulinemia, insulin resistance, chronic inflammation and intestinal dysbiosis, begging the pertinent question whether the adoption of dietary carbohydrate restriction can be beneficial for patients with cancer. This review summarizes the published data on the role of dietary carbohydrate restriction in the pathogenesis of Hepatocellular Carcinoma (HCC), the most frequent type of primary liver cancer. In addition to outlining the functional interplay between diet, the intestinal microbiome and immunity, the review underscores the importance of bile acids as interconnectors between the intestinal microbiota and immune cells.Copyright © 2023 Elsevier Ltd. All rights reserved.