Research progress on the regulation of microRNAs by traditional Chinese medicine in the prevention and treatment of hepatocellular carcinoma.

This review systematically summarizes the research progress on the regulation of microRNAs (miRNAs) by traditional Chinese medicine (TCM) in the prevention and treatment of hepatocellular carcinoma (HCC). As one of the most prevalent and lethal malignancies worldwide, the efficacy of current therapeutic strategies for HCC remains limited due to tumor heterogeneity and drug resistance, necessitating the exploration of novel treatment approaches. TCM, with its multi-target regulatory advantages, has demonstrated unique potential in influencing HCC progression by modulating miRNA expression, thereby affecting tumor cell proliferation, apoptosis, and invasion. This review provides an in-depth discussion of the biological pathways involved in TCM-mediated miRNA regulation, including transmembrane transport, targeted modulation, and bio-carrier-mediated delivery mechanisms. The dual role of miRNAs in HCC as either tumor suppressors or oncogenes is extensively analyzed. Moreover, we highlight the key mechanisms by which TCM modulates miRNA expression, such as epigenetic regulation, signal transduction pathway intervention, and anti-inflammatory and immunoregulatory effects, ultimately influencing HCC progression. Additionally, the clinical significance of serum miRNAs in HCC diagnosis, prognosis assessment, and correlation with pathological characteristics is discussed. Finally, we explore the challenges and future directions in HBV-associated HCC treatment via miRNA modulation, providing new insights into HCC prevention and therapeutic strategies.