在过去的几年中，由于接受不同免疫疗法治疗的癌症患者的预期寿命不断增加，免疫系统通过诱导免疫细胞介导的与患者结果相关的细胞毒性来调节肿瘤生长的重要性已得到强调。然而，肿瘤常常逃避通过不同机制实现的免疫监视。最近的研究证明了小非编码 RNA，例如 microRNA (miRNA)，在免疫调节分子的转录后控制中发挥着重要作用。多种方法已被用来鉴定针对参与逃避免疫识别的基因的 miRNA，包括针对 CTLA-4、PD-L1、HLA-G、主要组织相容性 I 类抗原加工机制 (APM) 的组件以及其他免疫反应的 miRNA。肿瘤中的相关基因。由于其功能，这些免疫调节 miRNA 可用作 (1) 诊断和预后生物标志物，从而区分肿瘤阶段并预测患者的结果以及对（免疫）疗法的反应和耐药性，以及 (2) 治疗肿瘤患者的治疗目标。这篇综述总结了 miRNA 在肿瘤介导的免疫逃逸中的作用，讨论了它们作为诊断、预后和预测工具的潜力，以及它们作为治疗方法的用途，包括替代应用方法，例如嵌合抗原受体 T 细胞。© 作者（s）（或其雇主）2024。根据 CC BY-NC 允许重复使用。禁止商业再利用。请参阅权利和权限。英国医学杂志出版。

The importance of the immune system in regulating tumor growth by inducing immune cell-mediated cytotoxicity associated with patients' outcomes has been highlighted in the past years by an increasing life expectancy in patients with cancer on treatment with different immunotherapeutics. However, tumors often escape immune surveillance, which is accomplished by different mechanisms. Recent studies demonstrated an essential role of small non-coding RNAs, such as microRNAs (miRNAs), in the post-transcriptional control of immune modulatory molecules. Multiple methods have been used to identify miRNAs targeting genes involved in escaping immune recognition including miRNAs targeting CTLA-4, PD-L1, HLA-G, components of the major histocompatibility class I antigen processing machinery (APM) as well as other immune response-relevant genes in tumors. Due to their function, these immune modulatory miRNAs can be used as (1) diagnostic and prognostic biomarkers allowing to discriminate between tumor stages and to predict the patients' outcome as well as response and resistance to (immuno) therapies and as (2) therapeutic targets for the treatment of tumor patients. This review summarizes the role of miRNAs in tumor-mediated immune escape, discuss their potential as diagnostic, prognostic and predictive tools as well as their use as therapeutics including alternative application methods, such as chimeric antigen receptor T cells.© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.