tRNA 是将转录组转化为蛋白质组的密码子解码器。 tRNA 研究领域因越来越多地发现特定 tRNA 修饰而兴奋不已，这些修饰由一组专门的 tRNA 修饰酶安装在特定的、进化上保守的位置，以及 tRNA 衍生的调节片段 (tsRNA) 的生物发生，这些片段通过以下方式表现出丰富的活性：多种机制。 tRNA 修饰的失调通常会产生病理后果，这种现象被称为“tRNA 调节病”。目前的证据表明，某些 tRNA 修饰酶和 tsRNA 可能作为有前景的诊断生物标志物和治疗靶点，特别是对于化疗耐药的癌症。在这篇综述中，我们讨论了阐明临床相关 tRNA 修饰和 tsRNA 功能的分子机制的最新发现，重点关注恶性肿瘤。我们还讨论了基于 tRNA/tsRNA 的疗法的治疗潜力，旨在为创新治疗策略的开发提供见解。进一步努力解开 tRNA 生物学固有的复杂性，有望为疾病的诊断和预后产生更好的生物标志物，从而推动改善健康的精准医学的发展。© 2024。作者。

tRNAs are codon decoders that convert the transcriptome into the proteome. The field of tRNA research is excited by the increasing discovery of specific tRNA modifications that are installed at specific, evolutionarily conserved positions by a set of specialized tRNA-modifying enzymes and the biogenesis of tRNA-derived regulatory fragments (tsRNAs) which exhibit copious activities through multiple mechanisms. Dysregulation of tRNA modification usually has pathological consequences, a phenomenon referred to as "tRNA modopathy". Current evidence suggests that certain tRNA-modifying enzymes and tsRNAs may serve as promising diagnostic biomarkers and therapeutic targets, particularly for chemoresistant cancers. In this review, we discuss the latest discoveries that elucidate the molecular mechanisms underlying the functions of clinically relevant tRNA modifications and tsRNAs, with a focus on malignancies. We also discuss the therapeutic potential of tRNA/tsRNA-based therapies, aiming to provide insights for the development of innovative therapeutic strategies. Further efforts to unravel the complexities inherent in tRNA biology hold the promise of yielding better biomarkers for the diagnosis and prognosis of diseases, thereby advancing the development of precision medicine for health improvement.© 2024. The Author(s).