通讯作者: 晏冬, doctoryd@163.com

DOI：10.12201/bmr.202611.00009

Research and application progress of microRNA-based liquid biopsy in the whole-course management of hepatocellular carcinoma

• 摘要：肝细胞癌（hepatocellular carcinoma，HCC）早期诊断困难，现行超声联合甲胎蛋白（alpha-fetoprotein，AFP）的监测策略对早期病灶灵敏度有限，且AFP在慢性肝病背景下假阳性率高。液体活检通过无创检测肿瘤相关分子，为破解上述困境提供了新路径。微小RNA（microRNA，miRNA）因循环稳定性好、检测技术成熟，已成为HCC液体活检最活跃的候选分子。本文概述miRNA的生物学特性与功能，沿HCC临床管理时间轴梳理其在早期诊断、预后评估及疗效监测中的研究进展，并展望当前挑战与未来方向。目前诊断端证据最为充分，预后监测已具备验证模型，疗效监测尚处早期探索阶段；技术层面仍面临标准化瓶颈、平台可比性不足及病因异质性导致模型外推困难等挑战。未来需建立多模态联合检测体系并推进前瞻性多中心队列研究，推动其向临床转化。

  关键词： 肝细胞癌; 液体活检; 微小核糖核酸; 生物标志物

   

  Abstract: Early diagnosis of hepatocellular carcinoma (HCC) remains challenging, as the current surveillance strategy combining ultrasound and alpha-fetoprotein (AFP) has limited sensitivity for early lesions, and AFP yields high false-positive rates in patients with chronic liver disease. Liquid biopsy, which enables non-invasive detection of tumor-derived molecules in body fluids, offers a new approach to overcome these limitations. MicroRNA (miRNA), owing to its high stability in circulation and relatively mature detection technologies, has become the most actively investigated candidate molecule for HCC liquid biopsy. This article outlines the biological characteristics and functions of miRNA, and reviews along the timeline of clinical management of HCC the research progress of miRNA-based liquid biopsy in early diagnosis, prognostic assessment, and therapeutic efficacy monitoring, followed by current challenges and future perspectives. At present, the evidence is most robust on the diagnostic side, prognostic monitoring has established validated models, and therapeutic efficacy monitoring remains at an early exploratory stage. Technically, the field still faces challenges including bottlenecks in standardization, limited comparability across detection platforms, and difficulties in model extrapolation caused by etiological heterogeneity. Future efforts should focus on establishing multimodal combined detection systems and conducting prospective multicenter cohort studies to advance the clinical translation of miRNA-based liquid biopsy.

  Key words: hepatocellular carcinoma; liquid biopsy; microRNA (miRNA); biomarker

  提交时间：2026-11-06

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-10-02	10.12201/bmr.202611.00009V1	下载

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