MRPL27 is a mitochondrial ribosomal protein that functions as a structural component of the mitochondrial large ribosomal subunit, participating in mitochondrial translation and oxidative phosphorylation. As a mitochondrial inner membrane-associated protein with RNA-binding capabilities, MRPL27 contributes to cellular energy metabolism through its involvement in mitochondrial translation elongation, respiratory electron transport, and ATP synthesis 1. Clinically, MRPL27 has emerged as a prognostic biomarker in multiple malignancies. In cholangiocarcinoma, MRPL27 mRNA is significantly upregulated in tumor tissues across all subtypes (intrahepatic, distal, and hilar/perihilar), and elevated expression correlates with worse overall survival and disease-free survival, establishing it as an independent risk factor 1. Similarly, in KRAS-mutant lung adenocarcinoma, MRPL27 overexpression positively correlates with unfavorable patient outcomes 2. MRPL27 was also identified as a hub gene in nonalcoholic fatty liver disease (NAFLD) pathogenesis, where it associates with oxidative phosphorylation dysregulation 3. These findings suggest that aberrant MRPL27 expression drives mitochondrial dysfunction in both metabolic and neoplastic diseases, positioning it as a potential therapeutic target and diagnostic biomarker across multiple disease contexts.