Ovarian cancer detection and prognosis: Unveiling circRNAs potential

Ovarian cancer remains one of the most aggressive and fatal gynecologic malignancies, primarily due to its asymptomatic onset, early metastatic potential, frequent resistance to conventional therapies, and the absence of effective tools for early detection and prognostic assessment. As a result, sensitive, specific and minimally invasive biomarkers are urgently needed to enable earlier detection, more accurate prediction of clinical outcomes and ongoing monitoring of therapeutic response. Circular RNAs (circRNAs) are endogenous RNA molecules formed by covalent backsplice junctions that render them highly resistant to exonuclease degradation. Many circRNAs serve as competitive endogenous RNAs that sequester microRNAs. This sequestration modulates key oncogenic signaling cascades, ultimately regulating cellular proliferation, migration, and apoptosis. Their exceptional stability, measurable abundance in body fluids and distinctive dysregulation in pathological states highlight their potential as both diagnostic and prognostic indicators. In fact, biomarker panels based on circRNA expression have achieved an area under the receiver operating characteristic curve of 0.923 for ovarian cancer detection. Individually, specific circRNAs have been shown to correlate with overall survival, histologic grade, tumor burden and other clinicopathologic features. In this review, by surveying all relevant data in major databases without language restrictions, we comprehensively update and analyze the latest molecular and clinical findings on the diagnostic and prognostic value of circRNAs in patients with ovarian cancer.