目的 探究肾透明细胞癌患者血清微小RNA（miR）-21及miR-27b与预后的关系。 方法 筛选2019年2月至2021年4月青海大学附属医院收治的118例肾透明细胞癌患者作为研究对象，另选取院内同期健康体检患者118例作为对照组，实时荧光定量聚合酶链反应（PCR）法检测所有受试者血清miR-21及miR-27b表达。比较肾透明细胞癌患者及健康对照患者的血清miR-21及miR-27b相对表达量；不同病理分期、Fuhrman分级肾透明细胞癌患者的血清miR-21及miR-27b表达及相关性；血清miR-21及miR-27b表达与肾透明细胞癌患者生存预后的关系。 结果 肾透明细胞癌组患者的血清miR-21及miR-27b表达量均高于健康对照组（P < 0.05）。Ⅲ期患者的血清miR-21表达量高于Ⅰ期（P < 0.05），Ⅳ期患者的血清miR-21表达量高于Ⅰ、Ⅱ、Ⅲ期（P < 0.05）。Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者的血清miR-27b表达量逐渐升高（P < 0.05）。病理分期与血清miR-21及miR-27b表达均呈正相关（P < 0.001）。Fuhrman分级Ⅰ、Ⅱ、Ⅲ级患者的血清miR-21、miR-27b表达量逐渐升高（P < 0.05）。Fuhrman分级与血清miR-21及miR-27b表达均呈正相关（P < 0.001）。miR-21高表达组与低表达组，miR-27b高表达组与低表达组患者的生存曲线比较，差异均有统计学意义（P < 0.05）。 结论 肾透明细胞癌患者的血清miR-21及miR-27b表达水平可反映患者的病情进展及预后生存情况。

Objective To explore the relationship between serum miRNA-21 and miR-27b levels and prognosis of patients with renal clear cell carcinoma. Methods A total of 118 patients with renal clear cell carcinoma admitted to the Qinghai University Hospital from February 2019 to April 2021 were selected as the study subjects， and another 118 healthy patients in the same period as the control group. Real time fluorescence quantitative polymerase chain reaction （PCR） was used to detect the expression of miR-21 and miR-27b in the serum of all subjects. The relative expression levels of serum miR-21 and miR-27b between the patients with renal clear cell carcinoma and healthy control patients were compared. The expression and correlation of serum miR-21 and miR-27b in the patients with renal clear cell carcinoma of different pathological stages and Fuhrman grading were analyzed. The relationship between the expression of serum miR-21 and miR-27b and the survival and prognosis of the patients was explored as well. Results The expression levels of serum miR-21 and miR-27b in the patients with renal clear cell carcinoma were higher than those in the healthy control group （P < 0.05）. The serum miR-21 expression level in stage Ⅲ patients was higher than in stageⅠ（P < 0.05）， while the serum miR-21 expression level in the stage Ⅳ patients was higher than that in stagesⅠ，Ⅱ， and Ⅲ（P < 0.05）. The expression level of miR-27b in the serum of patients gradually increased across the four stages， with a significant difference （P < 0.05）. The pathological staging was positively correlated with the expression of miR-21 and miR-27b （P < 0.001）. The expression levels of miR-21 and miR-27b in serum of patients gradually increased across grades Ⅰ， Ⅱ and Ⅲ by Fuhrman grading， with significant difference （P < 0.05）. Fuhrman grading was positively correlated with the serum miR-21 and miR-27b expression （P < 0.001）. There was a statistically significant difference in the survival curve between the miR-21 high expression group and the low expression group （P < 0.05）. There was a statistically significant difference in the survival curve between the high expression group and the low expression group of miR-27b （P < 0.05）. Conclusion The expression levels of serum miR-21 and miR-27b in patients with renal clear cell carcinoma is indicative of the progression and prognosis of the patient's condition.