| As the largest secondary lymphoid organ in the human body, the spleen plays a critical role in immune surveillance, antigen presentation, and maintenance of hematologic homeostasis. Accumulating evidence in recent years indicates that the structure and immune function of the spleen can be remodeled during tumor progression; in specific tumor types and inflammatory contexts, splenic myeloid expansion and immunosuppressive phenotypes may gradually become predominant. This process is closely associated with the abnormal activation of splenic extramedullary hematopoiesis (EMH), and is often accompanied by systemic immune homeostasis imbalance, thereby affecting the efficacy of immunotherapy and patient prognosis. Based on this, interventions targeting the immune regulatory function of the spleen have attracted increasing attention, and studies have explored the potential regulatory effects of strategies such as splenectomy, spleen-targeted nanodelivery, and low-dose splenic irradiation (LDSI) on systemic immunity. This review will summarize the changes in the structure and function of the spleen during tumor occurrence and development, sort out the potential molecular mechanisms and clinical intervention ideas for regulating systemic immunity with the spleen as a target, and discuss the feasibility and challenges of the spleen as a target for antitumor immunomodulation. |
