Advances in the Study of Exosomal MicroRNAs in Hepatocellular Carcinoma

近年来，肝细胞癌(HCC)已成为全球范围内最常见、最致命且最具侵袭性的肝脏恶性肿瘤之一。肝细胞癌患者拥有多种治疗选项，包括肝移植、手术切除、经皮消融、放疗以及经动脉和全身治疗。目前，免疫疗法也逐渐被引入肝细胞癌的治疗领域。尽管肝细胞癌的治疗方法持续进步，但肝癌的死亡率仍在逐年上升，预后情况亦令人担忧。微小RNA (microRNA)已成为近年来的研究焦点，它在生物体内广泛分布，作为生物标志物和治疗靶点参与肝细胞癌的发生和发展过程，在肿瘤微环境(TME)中调节肿瘤免疫。本文综述了外泌体microRNA在肝细胞癌中细胞间通讯的作用网络，阐释了其与肿瘤微环境的相互作用如何影响肝癌的进展，并探讨了miRNA靶向脂质代谢相关酶对肝癌进展的影响，以及低氧诱导的外泌体如何作用于肝细胞癌，旨在突破microRNA在HCC诊断、治疗和预后方面的研究进展。In recent years, hepatocellular carcinoma (HCC) has become one of the most common, deadly and aggressive liver malignancies worldwide. Patients with hepatocellular carcinoma have a variety of treatment options, including liver transplantation, surgical resection, percutaneous ablation, radiotherapy, and transarterial and systemic therapy. Immunotherapy is also now being introduced to the treatment of hepatocellular carcinoma. Despite continued advances in the treatment of hepatocellular carcinoma, the mortality rate of hepatocellular carcinoma continues to increase year after year, and the prognosis of hepatocellular carcinoma is of concern. MicroRNAs (microRNAs) have become a focus of research in recent years, which are widely distributed in organisms, participate in the process of hepatocellular carcinoma genesis and progression as biomarkers and therapeutic targets, and regulate tumor immunity in the tumor microenvironment (TME). In this paper, we reviewed the role network of exosomal microRNAs in intercellular communication in hepatocellular carcinoma, elucidated how their interactions with the tumor microenvironment affect hepatocellular carcinoma progression, and explored the effects of miRNA targeting of lipid metabolism-related enzymes on the progression of hepatocellular carcinoma, as well as how hypoxia-induced exosomes act in hepatocellular carcinoma, with the aim of breaking through the role of microRNAs in the diagnosis, treatment and prognosis of HCC Research progress in HCC diagnosis, treatment and prognosis.