[摘 要] 免疫检查点抑制剂（ICI）已广泛应用于多种实体肿瘤的治疗，循环T淋巴细胞亚群精细分型因其具有作为疗效预测标 志物的前景而备受关注。目前常用的ICI疗效预测标志物多依赖于肿瘤组织样本，存在取材困难且难以实现动态监测的局限性。 相比之下，循环T淋巴细胞亚群精细分型不仅能够反映T细胞的功能状态以预测ICI治疗反应，还因其取样便捷、微创安全的优 势，成为一种可行的动态检测手段。基于功能状态，循环T淋巴细胞亚群精细分型主要分为活化、增殖、衰老及耗竭等表型。活 化表型和增殖表型通常反映T细胞的活化、增殖和功能激活状态；而衰老表型与耗竭表型则反映T细胞储备下降，增殖及生存能 力减弱、存活期缩短，效应功能降低或失能的状态，这些功能状态与ICI的疗效密切相关。本文系统综述基于外周血T细胞功能 状态的精细分型在ICI治疗疗效预测中的最新研究进展，探讨不同功能状态的预测价值，分析其作为潜在预测工具的临床应用前 景与现实困境，为后续技术优化与临床转化提供参考。

[Abstract] Immune checkpoint inhibitors (ICIs) have been widely used in the treatment of various solid tumors, and the fine typing of circulating T lymphocyte subsets has attracted considerable attention due to its potential as a predictive biomarker for treatment efficacy. Currently, commonly used ICI efficacy predictive biomarkers mostly rely on tumor tissue samples, with limitations such as difficulty in sampling and dynamic monitoring. In contrast, the fine typing of circulating T lymphocyte subsets can not only reflect the functional status of T cells to predict the response to ICI treatment but also serve as a feasible dynamic detection method due to its advantages of convenience in sampling and minimal invasiveness. Based on its functional status, the fine typing of circulating T lymphocyte subsets can be mainly classified into activated, proliferative, senescent, and exhausted phenotypes. The activated and proliferative phenotypes usually indicate the activation, proliferation, and functional activation status of T cells, while the senescent and exhausted phenotypes reflect the state of T cells with reduced reserves, decreased proliferative and survival capacities, shortened lifespan, and impaired or incompetent effector functions. These functional states are closely related to the efficacy of ICIs. This article will systematically review the latest research progress in the application of fine typing based on the functional status of peripheral blood T cells in predicting ICI treatment efficacy, explore the predictive value of different functional states, and discuss the clinical application prospects and practical difficulties of this approach as a potential predictive tool, providing references for subsequent technical optimization and clinical transformation.

[基金项目] 国家自然科学基金（No. 82573449）；苏州市重大疾病多中心临床研究项目（No. DZXYJ202304）；苏州市姑苏卫生人才计划人才科研项 目（No. GSWS2022028）；苏州市应用基础研究(医疗卫生)科技创新项目（No. SYW2024095）；中核医疗核医创新项目 （No.ZHYLZD2025005）