内分泌治疗可显著改善雌激素受体阳性的乳腺癌患者的无病生存期和总生存期，但内分泌耐药是导致治疗失败的重要原因。微小RNA（ microRNA，miRNA）是肿瘤研究领域中的热点，新近研究证实miRNA的表达变化是乳腺癌耐药机制之一。 miRNA通过上调药物外排转运、抗凋亡蛋白、调节多药耐药信号传导网络等方式促成上皮⁃间质转化并形成肿瘤干细胞。 miRNA亦可能通过调节雌激素受体α表达、受体酪氨酸激酶信号传导、细胞生存信号及细胞凋亡等途径引发耐药。miRNA可能成为激素受体阳性乳腺癌的预后因子、内分泌治疗疗效评估的预测因子以及新的靶点。%Endocrine therapy is most effective adjuvant treatment for estrogen receptor( ER) positive breast cancer, signifi⁃cantly improving disease free survival and overall survival. However, endocrine treatment failure due to drug resistance leads to poor prognosis in some patients. Recently, microRNA( miRNA) is becoming a hotspot in the field of cancer research. More and more studies demonstrated that the expression and regulation of various miRNA was one of the key factors of drug resistance mechanisms of breast cancer. MiRNA stimulated epithelial⁃mesenchymal transition and cancer stem cells formation by modulating drug efflux transporters, anti⁃apoptotic protein and multidrug resistance signal transduction networks. Recent studies found that miRNA could control endocrine resistance mainly by regulating ERαexpression, tyrosine kinase receptor signal transduction, survival signaling and apoptosis pathway. Many studies showed that miRNA might be prognostic factor for hormone receptor positive breast cancer and predict factor for assessing the efficacy of endocrine therapy. As a new molecular marker, it is possible that miRNA can provide a new target to overcome endocrine therapy resistance so as to further improve endocrine therapy efficient of breast cancer.
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