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The dysregulation of microRNAs (miRNAs), which can act as oncogenes or tumor suppressors, plays a pivotal role in the initiation and progression of colorectal cancer (CRC) by regulating key cancer hallmarks such as proliferation, invasion, and metastasis through pathways including Wnt/β-catenin and TGF-β signaling. Over the past two decades, accumulating evidence has shown that miRNAs exhibit higher stability and tissue specificity compared to conventional protein biomarkers and provide a novel strategy for noninvasive detection of liquid biopsy, prognostic stratification, and treatment targets. Specific miRNAs such as miR-21, miR-92a, and miR-29a show promise for early CRC diagnosis, while miR-21, miR-141, and miR-200c are related to prognostic stratification. Compared to individual miRNAs, blood-based miRNA panels (e.g., those incorporating miR-21 and miR-92a) have demonstrated higher diagnostic accuracy for CRC screening, risk prediction, and guiding personalized treatment. Moreover, multisource miRNA profiles, using samples from tumor tissue, serum/plasma, stool, urine, and exosomes, further enhance clinical utility by capturing both local and systemic tumor-derived signals. In addition to their role as biomarkers, miRNA-based therapeutic candidates such as miR-16 mimics (e.g., TargomiR) are being explored alone or in combination with standard chemoradiotherapy, providing novel options for CRC treatment. Despite their promise, challenges remain in standardizing detection methods, improving tumor specificity, and developing safe and efficient in vivo delivery systems. Thus, this review systematically summarized miRNA biogenesis, their functional roles in CRC, and recent advances in diagnostic, prognostic, and therapeutic applications. We highlight promising miRNA-based therapeutics under development or in early-phase clinical trials and discuss future directions, including the need for standardized detection, improved specificity, dynamic monitoring, and emerging delivery strategies to achieve efficient and safe in vivo administration.

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MicroRNAs: Innovative Clinical Tools for Diagnosis, Prognosis, and Therapy in Colorectal Cancer

  • 章节

  • 发表日期：

    2026年

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  • Feiwu Long,
  • Wei Wang,
  • Ya Liu,
  • Chuanhua Yang,
  • Hailiang Ren,
  • Cuo Leng,
  • Peng Xiong,
  • Xinyue Tang,
  • Liyao Hu,
  • Lin Liu,
  • Chuanwen Fan

摘要

The dysregulation of microRNAs (miRNAs), which can act as oncogenes or tumor suppressors, plays a pivotal role in the initiation and progression of colorectal cancer (CRC) by regulating key cancer hallmarks such as proliferation, invasion, and metastasis through pathways including Wnt/β-catenin and TGF-β signaling. Over the past two decades, accumulating evidence has shown that miRNAs exhibit higher stability and tissue specificity compared to conventional protein biomarkers and provide a novel strategy for noninvasive detection of liquid biopsy, prognostic stratification, and treatment targets. Specific miRNAs such as miR-21, miR-92a, and miR-29a show promise for early CRC diagnosis, while miR-21, miR-141, and miR-200c are related to prognostic stratification. Compared to individual miRNAs, blood-based miRNA panels (e.g., those incorporating miR-21 and miR-92a) have demonstrated higher diagnostic accuracy for CRC screening, risk prediction, and guiding personalized treatment. Moreover, multisource miRNA profiles, using samples from tumor tissue, serum/plasma, stool, urine, and exosomes, further enhance clinical utility by capturing both local and systemic tumor-derived signals. In addition to their role as biomarkers, miRNA-based therapeutic candidates such as miR-16 mimics (e.g., TargomiR) are being explored alone or in combination with standard chemoradiotherapy, providing novel options for CRC treatment. Despite their promise, challenges remain in standardizing detection methods, improving tumor specificity, and developing safe and efficient in vivo delivery systems. Thus, this review systematically summarized miRNA biogenesis, their functional roles in CRC, and recent advances in diagnostic, prognostic, and therapeutic applications. We highlight promising miRNA-based therapeutics under development or in early-phase clinical trials and discuss future directions, including the need for standardized detection, improved specificity, dynamic monitoring, and emerging delivery strategies to achieve efficient and safe in vivo administration.