piRNAs and PIWI-like proteins in cancer and their future as biomarkers and therapeutic targets in lung cancer: a systematic review

Abstract

Introduction: This systematic review evaluates the current evidence on the role of PIWI-interacting RNAs (piRNAs) in lung cancer, emphasizing their diagnostic and therapeutic potential. Lung adenocarcinoma, a major global health concern, necessitates exploration of alternatives to traditional methods. piRNAs, small non-coding RNAs, are abnormally expressed in cancerous tissues and biological fluids, indicating their potential as biomarkers and therapeutic targets. Methods: A comprehensive search was performed in PubMed and ScienceDirect databases according to PRISMA guidelines. The search focused on studies examining piRNA expression, their diagnostic value in LUAD tissues and extracellular vesicles, and their therapeutic implications. Studies published from 2020 onward were included and evaluated for bias and quality. Results: Out of nineteen initially identified papers, five studies met the inclusion criteria. These studies identified specific piRNAs with elevated expression in LUAD, such as piR-hsa-26925 and piR-hsa-5444, which showed strong diagnostic performance (AUC = 0.833). Additionally, piRNAs from extracellular vesicles, including piR-hsa-164586, demonstrated potential for early detection of Non-Small Cell Lung Cancer (AUC = 0.624). Conclusions: piRNAs show promise as non-invasive biomarkers for early diagnosis and potential therapeutic targets in lung cancer. Further research is needed to validate these findings and understand the underlying mechanisms to improve clinical applications.