尽管几乎没有直接证据支持压力影响癌症发病率，但正如人类流行病学分析和小鼠模型所示，它确实影响肿瘤的演变、传播和治疗结果。生理和心理应激源的经历和反应可以引发神经和内分泌的改变，从而影响肿瘤微环境中的恶性（干）细胞、基质细胞和免疫细胞，以及肿瘤大环境中的全身因素。重要的是，压力引起的神经内分泌变化可以调节免疫反应，这一点已逐渐被发现。许多应激相关免疫调节分子（SAIM）可以通过与免疫细胞上相应的受体结合来重塑自然或治疗诱导的抗肿瘤反应。此外，压力可引起全身或局部代谢重编程并改变胃肠道微生物群的组成，从而间接调节抗肿瘤免疫。在这里，我们探索了将压力与癌症免疫对话中的扰动联系起来的复杂回路及其对癌症治疗方法的影响。© 2023。Springer Nature Limited。

Although there is little direct evidence supporting that stress affects cancer incidence, it does influence the evolution, dissemination and therapeutic outcomes of neoplasia, as shown in human epidemiological analyses and mouse models. The experience of and response to physiological and psychological stressors can trigger neurological and endocrine alterations, which subsequently influence malignant (stem) cells, stromal cells and immune cells in the tumour microenvironment, as well as systemic factors in the tumour macroenvironment. Importantly, stress-induced neuroendocrine changes that can regulate immune responses have been gradually uncovered. Numerous stress-associated immunomodulatory molecules (SAIMs) can reshape natural or therapy-induced antitumour responses by engaging their corresponding receptors on immune cells. Moreover, stress can cause systemic or local metabolic reprogramming and change the composition of the gastrointestinal microbiota which can indirectly modulate antitumour immunity. Here, we explore the complex circuitries that link stress to perturbations in the cancer-immune dialogue and their implications for therapeutic approaches to cancer.© 2023. Springer Nature Limited.