Exploring Microrna Expression Patterns in Early Detection and Progression of Hepatocellular Carcinoma- Systematic Review

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, with most cases diagnosed at an advanced stage due to limitations in current diagnostic tools. Traditional biomarkers such as alpha-fetoprotein lack the sensitivity and specificity needed for early detection. MicroRNAs (miRNAs) have emerged as promising molecular biomarkers, but evidence remains fragmented and inconsistent, highlighting the need for a systematic synthesis of current findings. Objective: This systematic review aims to evaluate the diagnostic and prognostic value of specific microRNAs in the early detection and monitoring of hepatocellular carcinoma. Methods: A systematic review was conducted following PRISMA guidelines. Literature searches were performed across PubMed, Scopus, Web of Science, and Cochrane Library for studies published between January 2019 and July 2024. Inclusion criteria encompassed observational and case-control studies assessing miRNA expression in HCC patients. Studies were screened independently by two reviewers, and data were extracted using a standardized form. Risk of bias was assessed using the Newcastle-Ottawa Scale. Due to heterogeneity in methodologies, a qualitative synthesis was performed. Results: Eight studies involving 2,342 participants were included. Key miRNAs identified with strong diagnostic or prognostic relevance included miR-21, miR-122, miR-125b, miR-224, and exosomal miR-500a-3p. Reported sensitivities ranged from 72% to 85%, with area under the curve (AUC) values up to 0.91. Many miRNAs correlated significantly with tumor stage, recurrence, and survival outcomes. Risk of bias was generally low to moderate across included studies. Conclusion: MicroRNAs show substantial potential as non-invasive biomarkers for the early diagnosis and monitoring of HCC. However, variability in detection methods and limited population diversity call for further large-scale, standardized studies to confirm their clinical applicability.