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Purpose: A series of clinical studies have established the safety and efficacy of transcatheter arterial chemoembolization (TACE) with gelatin sponge microparticles (GSMs) in treating hepatocellular carcinoma (HCC).HCC can lead to obvious necrosis inside tumors,especially larger ones,although it is unclear whether such necrotic tumor tissue can induce favorable immune reactions against the tumor.Myeloid-derived suppressor cells (MDSCs) have immunosuppressive functions and are currently considered a very important cell type affecting tumor immunity.This study observed changes in MDSC frequency in peripheral blood before and after GSM-TACE to evaluate the effect on the immune function of HCC patients.Methods: Eight patients diagnosed with HCC underwent GSM-TACE treatment in the Hepatobiliary Interventional Department of Beijing Tsinghua Chang Gung Hospital,Beijing,China;we followed up with the patients over a period of 30 days post-surgery.We used flow cytometry (FCM) to quantify the frequency of MDSCs in peripheral blood before TACE,10 days after surgery and 30 days after surgery.Results: MDSC frequency after GSM-TACE had a significant downward trend.Pre-TACE,it was 30.73％ ± 11.93％,decreasing to 18.60％ ± 11.37％ at 10 days after operation.This decrease was not statistically significant (P ＞ 0.05).MDSC frequency was even lower 30 days after TACE (7.63％ ± 7.32％) than at 10 days after TACE (P ＜ 0.05),and there was a significant difference compared with pre-TACE (P ＜ 0.001).We evaluated tumor response at 30 days after GSM-TACE according to the Modified Response Evaluation Criteria in Solid Tumors (mRECIST),and all eight patients showed partial response (PR).Conclusion: Our results confirmed that GSM-TACE was beneficial for improving anti-tumor immunity in the treatment of HCC.