Circulating miRNA as diagnostic tools for gynecological diseases and their applications in biosensor development

MicroRNAs (miRNAs) have emerged as robust biomarkers for diagnosing and prognosing gynecological diseases due to their disease-specific expression and remarkable stability in body fluids. Despite the inherent instability of RNA molecules, circulating miRNAs remain well protected through encapsulation in extracellular vesicles (EVs) or binding to RNA-binding proteins and lipoproteins, enabling reliable clinical detection. This review summarizes circulating miRNAs' biogenesis and clinical relevance, emphasizing their roles in both malignant (e.g., ovarian and endometrial cancers) and benign (e.g., endometriosis and preeclampsia) conditions. Several electrochemical, fluorescent, and colorimetric biosensing platforms have been developed for sensitive and specific miRNA detection. However, most research focuses on cancer-associated miRNAs, leaving those linked to non-malignant diseases largely overlooked. To bridge this gap, this review highlights the need for broader exploration of underrepresented miRNAs and the development of multiplexed biosensing strategies to enhance diagnostic precision. Integrating advanced detection technologies with comprehensive biomarker discovery could significantly improve diagnostic accuracy, expand clinical applications, and accelerate the adoption of miRNA biosensors in point-of-care testing (POCT).