Emerging role of non‑coding RNAs in the progression of MASLD‑driven hepatocellular carcinoma (Review).

Metabolic dysfunction‑associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide and a leading cause of liver‑related morbidity and mortality. MASLD encompasses a pathological spectrum ranging from metabolic dysfunction‑associated steatohepatitis to cirrhosis and hepatocellular carcinoma (HCC), making it the fastest‑growing contributor to the global incidence of HCC. Non‑coding RNAs (ncRNAs), once regarded as 'genomic dark matter', are increasingly recognised as key regulatory molecules in a variety of liver diseases. However, their systematic involvement in the malignant progression from MASLD to HCC remains incompletely understood. Emerging evidence suggests that ncRNAs play critical roles in modulating the major pathophysiological processes underlying MASLD‑driven HCC progression, including dysregulated lipid metabolism, chronic inflammation, oxidative stress, immune imbalance and gut microbiota disruption. The present review systematically examines the specific functions of major ncRNA classes, including microRNAs, long ncRNAs and circular RNAs, in the pathogenesis of MASLD‑driven HCC. In addition, given their considerable diagnostic and therapeutic potential, the present review evaluates the prospects of ncRNAs as novel biomarkers and therapeutic targets to facilitate the early detection and precision treatment of MASLD‑driven HCC.