The role of tumor-associated endothelial cells in malignant progression and immune evasion of liver cancer.

Recent studies have revealed that the malignant progression of hepatocellular carcinoma (HCC) not only stems from tumor cell-intrinsic genetic alterations but is dynamically regulated by the tumor microenvironment (TME). As a pivotal component of TME, tumor-associated endothelial cells (TECs) critically drive HCC progression through dual mechanisms of vascular abnormality and immune modulation. TECs establish a pro-tumorigenic niche by constructing disordered vascular networks while concurrently secreting immunosuppressive factors that induce immune cell dysfunction. This review systematically examines the molecular mechanisms underlying the dynamic transition from hepatic endothelial cells to TECs, identifies key TEC subtypes mediating tumor angiogenesis and immune evasion, and elucidates their crosstalk with immunosuppressive components. Additionally, we highlight TEC-specific biomarkers associated with clinical HCC progression and synthesize current clinical trials targeting TEC-mediated pathways. These findings provide novel insights for developing precision therapies that disrupt the TEC-TME-immune axis in HCC.