A systematic review of MicroRNA (miRNA) biomarkers in the diagnosis and prognosis of hepatocellular carcinoma.

[BACKGROUND] Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality in the world, with most cases being diagnosed in an advanced stage of the disease. Small non-coding microRNAs (miRNAs), which play a crucial role in regulating gene expression, have emerged as potential diagnostic, prognostic, and therapeutic targets for HCC. This systematic review aims to review the current evidence on the diagnostic and prognostic significance of miRNAs in HCC METHODS: A comprehensive literature search by using PubMed, Scopus, Web of Science, and Google Scholar was conducted, considering papers published between January 2013 and June 2025. The review followed PRISMA 2020. The studies that fit the criteria were human studies and focused on the effects of miRNAs on the diagnosis, prognosis, or response to treatment of HCC. Data extraction was performed independently by 2 reviewers, and the quality of included studies was assessed with use of the Newcastle-Ottawa Scale. Narrative synthesis was performed, and sensitivity, specificity, and AUC measurements were extracted as appropriate.

[FINDINGS] Out of 1,572 articles, 300 studies met the criteria for inclusion. The analysis looked at over 120 different miRNAs from biological samples like blood, serum, tissue, and plasma. Although many miRNAs, such as miR-21, miR-122, and miR-199a, show significant promise for diagnosis and prognosis, their application in clinical settings necessitates thorough validation in extensive, multicentre studies. A few miRNAs showed good diagnostic accuracy (AUC & gt; 0.85) and had links to tumor stage, metastasis, and how long patients lived. Still, differing sample types and detection methods made the meta-analysis difficult.

[CONCLUSION] miRNAs show potential as non-invasive markers for early detection and prognosis of HCC. This review emphasises the potential of miRNAs as non-invasive indicators for the diagnosis and prognosis of HCC. Nonetheless, the variability across studies and the absence of methodological consistency restrict their prompt application in clinical settings. It is crucial to validate findings through extensive, multicentre studies and to integrate them with traditional diagnostic methods to guarantee their relevance in clinical practice. Future research should focus on confirming miRNA panels and integrating them into current diagnostic methods.