儿童癌症仍然是 1-14 岁儿童疾病相关死亡的主要原因。一些风险因素已被最终确定，包括接触农药、高剂量辐射和特定的遗传综合征，但大多数事件的病因仍不清楚。肿瘤微环境（TME）包括基质细胞、脉管系统、成纤维细胞、脂肪细胞和不同的免疫细胞亚群。 TME 在癌发生、癌症形成、进展、传播和治疗耐药性中发挥着至关重要的作用。此外，自噬似乎是 TME 的重要调节因子并控制肿瘤免疫。自噬是一种进化上保守的细胞内过程。它能够利用溶酶体介导的途径降解和回收长寿命的大分子或受损的细胞器。自噬在复杂的肿瘤性 TME 中的多方面作用可能取决于具体情况。自噬可能通过消除不健康的细胞内成分和蛋白质、调节免疫细胞的抗原呈递以及支持抗癌免疫反应，在早期肿瘤发生过程中发挥肿瘤抑制机制的作用。另一方面，自噬失调可能通过促进基因组损伤和不稳定而导致肿瘤进展。这种观点提供了一系列影响 TME 特征和转移过程的调节物质。骨和软组织肉瘤中的间充质细胞及其信号通路比儿童和青少年的上皮细胞发挥着更重要的作用。 TME 在儿科恶性肿瘤中的研究基本上仍是未知的，这个独特的集合可能有助于囊括该领域的新颖进展。© 2024。作者。

Pediatric cancer remains the leading cause of disease-related death among children aged 1-14 years. A few risk factors have been conclusively identified, including exposure to pesticides, high-dose radiation, and specific genetic syndromes, but the etiology underlying most events remains unknown. The tumor microenvironment (TME) includes stromal cells, vasculature, fibroblasts, adipocytes, and different subsets of immunological cells. TME plays a crucial role in carcinogenesis, cancer formation, progression, dissemination, and resistance to therapy. Moreover, autophagy seems to be a vital regulator of the TME and controls tumor immunity. Autophagy is an evolutionarily conserved intracellular process. It enables the degradation and recycling of long-lived large molecules or damaged organelles using the lysosomal-mediated pathway. The multifaceted role of autophagy in the complicated neoplastic TME may depend on a specific context. Autophagy may function as a tumor-suppressive mechanism during early tumorigenesis by eliminating unhealthy intracellular components and proteins, regulating antigen presentation to and by immune cells, and supporting anti-cancer immune response. On the other hand, dysregulation of autophagy may contribute to tumor progression by promoting genome damage and instability. This perspective provides an assortment of regulatory substances that influence the features of the TME and the metastasis process. Mesenchymal cells in bone and soft-tissue sarcomas and their signaling pathways play a more critical role than epithelial cells in childhood and youth. The investigation of the TME in pediatric malignancies remains uncharted primarily, and this unique collection may help to include novel advances in this setting.© 2024. The Author(s).