We found that metabolism pathways, particularly genes associated with fatty acid metabolism, such as CBR4, CPT2, ACAA2, ECHDC2 and ACAA1, as well as glycoprotein-related genes such as CLEC1A, ADAMTS4, COL25A1, CLEC3B, ADAMTS1 and CLEC2B were enriched in tumours with low immune-ITH (Fig. 5c, d), indicating the distinct metabolism pathways were potentially involved in maintaining the immune status of TME in HCC. This evidence concerns the gene ACAA2 and hepatocellular carcinoma.