不同的抗肿瘤治疗方案不断涌现，包括化疗、免疫治疗和靶向治疗。然而，其疗效仍然不尽如人意。黄芪多糖是从黄芪的干燥根部提取的重要生物活性成分。研究发现，黄芪多糖在增加抗肿瘤治疗的敏感性、减少抗肿瘤治疗的副作用、逆转抗肿瘤药物耐药性等方面具有重要意义。本综述关注黄芪多糖在肿瘤免疫微环境中的作用，在巨噬细胞、树突状细胞、自然杀伤细胞、T淋巴细胞和B淋巴细胞上进行了调节免疫反应的研究。我们发现黄芪多糖可以促进巨噬细胞、树突状细胞、自然杀伤细胞、T淋巴细胞和B淋巴细胞的活性，并诱导多种细胞因子和趋化因子的表达。此外，我们总结了黄芪多糖在消化道肿瘤患者中的临床应用。我们总结了黄芪多糖对消化道肿瘤的有效机制，包括诱导细胞凋亡、抑制增殖、调节免疫活性、增强抗癌效应和化疗敏感性。因此，考虑到黄芪多糖在肿瘤免疫微环境中的多种功能及其临床疗效，将其与免疫疗法等抗肿瘤治疗方法相结合，可能为当前治疗方法的瓶颈提供新的突破口。© 2023. Springer Science+Business Media, LLC.

Various new treatments are emerging constantly in anti-tumor therapies, including chemotherapy, immunotherapy, and targeted therapy. However, the efficacy is still not satisfactory. Astragalus polysaccharide is an important bioactive component derived from the dry root of Radix astragali. Studies found that astragalus polysaccharides have gained great significance in increasing the sensitivity of anti-tumor treatment, reducing the side effects of anti-tumor treatment, reversing the drug resistance of anti-tumor drugs, etc. In this review, we focused on the role of astragalus polysaccharides in tumor immune microenvironment. We reviewed the immunomodulatory effect of astragalus polysaccharides on macrophages, dendritic cells, natural killer cells, T lymphocytes, and B lymphocytes. We found that astragalus polysaccharides can promote the activities of macrophages, dendritic cells, natural killer cells, T lymphocytes, and B lymphocytes and induce the expression of a variety of cytokines and chemokines. Furthermore, we summarized the clinical applications of astragalus polysaccharides in patients with digestive tract tumors. We summarized the effective mechanism of astragalus polysaccharides on digestive tract tumors, including apoptosis induction, proliferation inhibition, immunoactivity regulation, enhancement of the anticancer effect and chemosensitivity. Therefore, in view of the multiple functions of astragalus polysaccharides in tumor immune microenvironment and its clinical efficacy, the combination of astragalus polysaccharides with antitumor therapy such as immunotherapy may provide new sparks to the bottleneck of current treatment methods.© 2023. Springer Science+Business Media, LLC.