冷冻消融（CRA）是目前原发性肝癌（简称肝癌）的有效根治手段之一，通过超低温诱导肿瘤细胞坏死、微血管损伤及免疫激活，兼具精准消融与重要解剖结构保护优势。对于小肝癌（最大径≤3 cm），CRA的疗效与射频消融（RFA）、微波消融（MWA）相当，且在处理邻近血管、胆囊等高风险部位肝癌病灶时的并发症发生率更低；针对最大径为3~5 cm的肝癌，CRA局部复发率低于RFA和MWA，且疼痛反应更轻；对于最大径≥5 cm的大肝癌，CRA需联合肝动脉化疗栓塞术或肝动脉灌注化疗等以提高控制率。此外，CRA可诱发免疫反应，与免疫检查点抑制剂具有协同效应，动物实验及初步临床研究结果证实其安全性及抗肿瘤活性，但对肝癌的确切疗效仍有待高级别循证医学证据验证。未来研究应聚焦于明确联合治疗的生物标记物及个体化策略，探索多模态治疗优化组合。

Cryoablation (CRA) is currently an effective radical treatment for primary liver cancer (hepatocellular carcinoma). It induces tumor cell necrosis, microvascular damage, and immune activation through ultra-low temperatures, offering advantages of precise ablation and protection of critical anatomical structures. For small hepatocellular carcinoma (maximum diameter ≤3 cm), its efficacy is comparable to that of radiofrequency ablation (RFA) and microwave ablation (MWA), with a lower complication rate when tumors are adjacent to high-risk sites such as blood vessels or the gallbladder. For tumors measuring 3-5 cm in diameter, CRA is associated with a lower local recurrence rate than RFA and MWA, along with milder pain response. In large hepatocellular carcinoma (maximum diameter ≥5 cm), combination with transarterial chemoembolization/hepatic arterial infusion chemotherapy is required to improve control rates. CRA can trigger an immune response and exhibits a synergistic effect with immune checkpoint inhibitors. Animal studies and preliminary clinical research confirm its safety and anti-tumor activity; however, high-level evidence -based medicine evidence is still needed to verify its efficacy in hepatocellular carcinoma. Future efforts should focus on identifying biomarkers for combination therapy, developing individualized strategies, and exploring optimized multimodal treatment regimens.