肝细胞癌（HCC）是一种对人类生命和健康构成严重威胁的消化系统恶性肿瘤。临床常用的化疗药物疗效有限且副作用较大。因此，寻找有效且安全的替代品，天然多糖（NPs）成为当务之急。本文详细总结了NPs在体外、动物实验和临床试验中抗HCC活性。此外，添加NPs可以减轻化疗药物的有害效应，如免疫毒性、骨髓抑制、氧化应激等。潜在机制与凋亡和细胞周期阻滞的诱导、血管生成的阻断、侵袭和转移的阻止、免疫活性的刺激和MircoRNA的靶向相关。在此基础上，我们进一步阐明了抗HCC活性可能与NPs的单糖组成、分子量（Mw）、构象特征和结构修饰有关。此外，由于其良好的理化性质，广泛应用于化疗药物和小分子成分的传递中作为药物载体。本综述为应用NPs的抗HCC活性提供了有利的理论基础。版权所有©2023 Elsevier B.V. 发表。

Hepatocellular carcinoma (HCC) is a malignant tumor of the digestive system that poses a serious threat to human life and health. Chemotherapeutic drugs commonly used in the clinic have limited efficacy and heavy adverse effects. Therefore, it is imperative to find effective and safe alternatives, and natural polysaccharides (NPs) fit the bill. This paper summarizes in detail the anti-HCC activity of NPs in vitro, animal and clinical trials. Furthermore, the addition of NPs can reduce the deleterious effects of chemotherapeutic drugs such as immunotoxicity, bone marrow suppression, oxidative stress, etc. The potential mechanisms are related to induction of apoptosis and cell cycle arrest, block of angiogenesis, invasion and metastasis, stimulation of immune activity and targeting of MircoRNA. And on this basis, we further elucidate that the anti-HCC activity may be related to the monosaccharide composition, molecular weight (Mw), conformational features and structural modifications of NPs. In addition, due to its good physicochemical properties, it is widely used as a drug carrier in the delivery of chemotherapeutic drugs and small molecule components. This review provides a favorable theoretical basis for the application of the anti-HCC activity of NPs.Copyright © 2023. Published by Elsevier B.V.