The role of circular RNA in the occurrence and progression of gastric cancer: Emerging perspectives on its use as diagnostic and therapeutic biomarkers and therapeutic targets.

Gastric cancer (GC) is a significant public health issue worldwide due to its high rates of morbidity and mortality. Its complex pathological classification and frequent late diagnosis present substantial challenges to clinical treatment. Although chemotherapy is somewhat effective in treating advanced GC, drug resistance in tumor cells continues to hinder progress in treatment. Circular RNAs (circRNAs) are a type of non-coding RNA with a unique, closed, single-stranded, circular structure. CircRNAs primarily act as "molecular sponges" that absorb microRNAs or specific proteins, thereby potentially influencing multiple downstream signaling pathways. This study thoroughly investigates the biological functions of circRNAs in GC development and reviews their exploratory potential in GC diagnosis and treatment, while also acknowledging the current limitations in translating these findings to clinical practice. Regarding diagnosis, the study covers early screening, treatment monitoring, and prognosis evaluation. Regarding treatment, the study focuses on cell cycle regulation, metabolic reprogramming, immune microenvironment remodeling, and intervention in drug resistance mechanisms. Additionally, the study objectively analyzes the technical bottlenecks and scientific challenges encountered during the clinical translation of circRNAs. It also proposes a comprehensive vision for a medicine system for GC based on circRNAs; however, this vision requires extensive validation and integration with existing clinical frameworks.