摘要：膀胱癌是全球第六大常见癌症，发病率和死亡率高居泌尿系统肿瘤第 2位，然而，膀胱镜和尿细胞学检查 均各有其局限性。因此，迫切需要开发敏感度和特异度均较高的新型标志物用于膀胱癌的早期诊断。微小 RNA （microRNA） 是一类长约22 nt的非编码RNA，普遍存在于生物体内。大量研究已经证实，microRNA在肿瘤的 发生、发展过程中起着至关重要的作用；另外越来越多的研究表明，大量的 microRNA 在膀胱癌中存在差异表 达，且能在血液、尿液中稳定存在，有望成为诊断膀胱癌的强有力生物标志物。论文就尿液中 microRNA在膀胱 癌中的诊断作用作一综述。

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吴海超,陈振杰,丁明霞. 尿液中microRNA在膀胱癌诊断中的研究进展[J]. 泌尿外科杂志（电子版）,2021,13(2):59-63. DOI:10.3969/j.issn.1674-7410.2021.02.014.

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膀胱癌是全球第六大常见癌症，其发病率和死 亡率更是在泌尿系统肿瘤中高居第 2位，仅次于前列 腺癌[1] 。而且男性发病率和死亡率约为女性的4倍，严 重影响到男性的寿命和生活质量[2] 。目前用于诊断膀 胱癌的手段众多，不过诊断的金标准仍是侵入性膀 胱镜检查，但膀胱镜检查不仅有耗时长、价格昂 贵、易引发并发症等缺点，还会给患者带来一定的 痛苦[3,4] 。尿细胞学检查因其较高的诊断特异度，在 临床上也被列为诊断膀胱癌的一种常用手段，但其 局限性也非常明显，即敏感度较低，对低级别乳头 状尿路上皮癌的诊断较为困难[5] 。因此，有必要充分 利用当前成熟的基因技术，进一步了解膀胱癌的分 子机制，以开发新的兼具特异度和敏感度的非侵入 性检查手段，用于膀胱癌的早期精确诊断及指导临 床决策。

microRNA 是一类长约 22 nt 的非编码 RNA， 目前诸多研究表明 microRNA 在多种人类癌症中异 常表达，且在这些癌症的发生、发展和转移中起着 重要作用[6-8] 。有证据显示，在膀胱癌患者的尿液样 本中存在多种可检测的 microRNA，这些表达异常的 microRNA可能在启动癌变或驱动进展中扮演着重要的角色[9,10] ，因此尿液中 microRNA 分子检测技术将 有望成为膀胱癌潜在的新型诊断手段，为膀胱癌 的诊断提供强有力的帮助。本篇综述将介绍尿液中 microRNA对膀胱癌的诊断作用。

1 microRNA 的功能及生物合成

2 尿 microRNA 与膀胱癌
    2.1 单个尿 microRNA 的诊断意义
    2.2 尿microRNA组合的诊断意义

3 结语

3 结语 

近年来医学界对 microRNA 在各种疾病进展中 所发挥的作用越来越重视，尤其是在肿瘤领域。通 过对 microRNA 深入研究可以更透彻地了解膀胱癌 的分子机制，了解其发生、发展及转移的机制，从 而帮助临床医生和患者早期发现并治疗膀胱癌。尿 液作为天然体液，简便易收集，具有明显的优势， 是检测 microRNA 的上佳样本。尿液中 microRNA 在诊断膀胱癌的准确性和灵敏性方面都展现出了不 俗的优势，有望成为诊断和随诊膀胱癌可靠的生物 标志物。

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