The TACE+L+I group had a significantly higher incidence of hypothyroidism compared to the TACE+L group (RR = 1.81, 95%CI:1.20, 2.71, <i>p</i><0.05), but there was no significant difference in other adverse events, such as hypertension, diarrhea, hand-foot syndrome, fatigue, elevated AST, elevated ALT, decreased appetite, hypothyroidism, abdominal pain, thrombocytopenia, rash, and nausea.<h4>Conclusion</h4>ICIs significantly improved the survival outcome of uHCC treated with TACE+L, and increased the incidence of hypothyroidism. This evidence concerns the gene GPT and hypothyroidism.