Barjasteh Amir Hossein, Jaseb Mazhar AleKassar Rawa, Al-Asady Abdulridha Mohammed, Latifi Hanieh, Avan Amir, Khazaei Majid, Ryzhikov Mikhail, Hassanian Seyed Mahdi
Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Med Sci. 2025 Apr 1;50(4):202-219. doi: 10.30476/ijms.2024.102910.3622. eCollection 2025 Apr.
Colorectal cancer (CRC) ranks among the most prevalent cancers worldwide and is the fourth leading cause of cancer-related deaths. Metastasis poses a significant obstacle in CRC treatment, as distant metastasis, particularly to the liver, remains the primary cause of mortality. Colorectal liver metastasis (CRLM) occurs frequently due to the liver's direct vascular connection to the colorectal region via the portal vein. Standard treatment approaches for CRLM are limited; only a few patients qualify for surgical intervention, resulting in a persistently low survival rate. Additionally, resistance to chemotherapy is common, emphasizing the need for more effective targeted therapies. Emerging evidence highlights the pivotal role of microRNAs (miRNAs) in modulating critical pathways associated with CRLM, including tumor invasion, epithelial-mesenchymal transition, and angiogenesis. MiRNAs exhibit dual functions as tumor suppressors and oncogenes by targeting multiple genes, thus playing a complex role in both the initiation and progression of metastasis. The regulatory mechanisms of miRNAs could help to identify novel biomarkers for early diagnosis and prognosis of CRLM, as well as promising therapeutic targets to overcome chemoresistance. Despite numerous studies on miRNA involvement in CRC metastasis, dedicated reviews focusing on miRNAs and CRLM remain scarce. This review aims to approach targeted therapies by examining the current understanding of miRNA involvement in CRLM and exploring their potential as diagnostic, prognostic, and therapeutic agents. Through an integrative approach, we aim to provide insights that could transform CRLM management and improve patient outcomes.
结直肠癌（CRC）是全球最常见的癌症之一，也是癌症相关死亡的第四大主要原因。转移是CRC治疗中的一个重大障碍，因为远处转移，尤其是肝转移，仍然是死亡的主要原因。由于肝脏通过门静脉与结直肠区域直接相连，结直肠癌肝转移（CRLM）很常见。CRLM的标准治疗方法有限；只有少数患者符合手术干预条件，导致生存率持续较低。此外，对化疗的耐药性很常见，这凸显了需要更有效的靶向治疗。新出现的证据强调了微小RNA（miRNA）在调节与CRLM相关的关键途径中的关键作用，包括肿瘤侵袭、上皮-间质转化和血管生成。miRNA通过靶向多个基因发挥肿瘤抑制因子和癌基因的双重功能，因此在转移的起始和进展中都发挥着复杂的作用。miRNA的调控机制有助于识别CRLM早期诊断和预后的新生物标志物，以及克服化疗耐药性的有前景的治疗靶点。尽管有大量关于miRNA参与CRC转移的研究，但专注于miRNA和CRLM的专门综述仍然很少。本综述旨在通过研究目前对miRNA参与CRLM的理解，并探索它们作为诊断、预后和治疗剂的潜力，来探讨靶向治疗。通过综合方法，我们旨在提供能够改变CRLM管理并改善患者预后的见解。
