非编码RNA协同调控非小细胞肺癌放疗敏感性的分子机制与临床应用前景
Molecular Mechanisms and Clinical Application Prospects of Non-Coding RNA Synergistic Regulation of Radiosensitivity in Non-Small Cell Lung Cancer
摘要: 非小细胞肺癌(NSCLC)占所有肺癌病例的85%以上，放疗抵抗是导致治疗失败和预后不良的关键因素。近年来，长链非编码RNA (lncRNAs)与微小RNA (miRNAs)被证实通过形成复杂的竞争性内源RNA (ceRNA)调控网络，深刻影响肿瘤细胞对电离辐射的响应。本文系统综述了lncRNA-miRNA协同调控NSCLC放疗敏感性的分子机制，重点阐述了核心调控轴(如HNF1A-AS1/miR-92a-3p/MAP2K4、CBR3-AS1/miR-409-3p/SOD1、WDR11-DT等)在DNA损伤修复、细胞凋亡、铁死亡及细胞周期检查点调控中的关键作用。同时，本文总结了具有放疗敏感性预测价值的非编码RNA特征谱，探讨了基于ceRNA网络的靶向增敏策略(包括miRNA模拟物/抑制剂、纳米递送系统及联合放疗方案)的临床转化进展。最后，针对当前研究面临的时空异质性、递送效率及多组学整合等挑战，提出了未来研究的方向与精准放疗时代的个体化治疗展望。
Abstract: Non-small cell lung cancer (NSCLC) accounts for more than 85% of all lung cancer cases, and radioresistance is a key factor leading to treatment failure and poor prognosis. In recent years, long non-coding RNAs (lncRNAs) and microRNAs (miRNAs) have been shown to profoundly affect the response of tumor cells to ionizing radiation by forming a complex competitive endogenous RNA (ceRNA) regulatory network. This article systematically reviews the molecular mechanisms of lncRNA-miRNA synergistic regulation of radiosensitivity in NSCLC, focusing on the key roles of core regulatory axes (such as HNF1A-AS1/miR-92a-3p/MAP2K4, CBR3-AS1/miR-409-3p/SOD1, WDR11-DT, etc.) in DNA damage repair, apoptosis, ferroptosis, and cell cycle checkpoint regulation. This article summarizes the characteristic profiles of non-coding RNAs with predictive value for radiosensitivity and discusses the clinical translational progress of targeted sensitization strategies based on ceRNA networks (including miRNA mimics/inhibitors, nanodelivery systems, and combined radiotherapy regimens). Finally, addressing the challenges of spatiotemporal heterogeneity, delivery efficiency, and multi-omics integration currently facing research, it proposes future research directions and a vision for personalized treatment in the era of precision radiotherapy.
文章引用：张枫皓. 非编码RNA协同调控非小细胞肺癌放疗敏感性的分子机制与临床应用前景[J]. 临床医学进展, 2026, 16(6): 1317-1328. https://doi.org/10.12677/acm.2026.1662342

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