Ribosomal RNA Modifications as Emerging Biomarkers in Cancer Diagnostics

Recent advances in epitranscriptomics have revealed ribosomal RNA (rRNA) modifications as dynamic biomarkers for cancer detection. This review synthesizes evidence from 22 studies (2018-2025), demonstrating that tissue-specific rRNA modification patternstermed "epitranscriptomic fingerprints"enable early cancer diagnosis with >96% accuracy. Unlike conventional methods such as CT imaging and tissue biopsies that often require invasive procedures and lack sensitivity for early-stage tumors, epitranscriptomic profiling offers a minimally invasive alternative with unprecedented precision. Nanopore direct RNA sequencing (DRS) technology allows real-time mapping of chemical modifications (e.g., 2'-O-methylation and pseudouridylation) in native rRNA, identifying hypomodification as a universal cancer signature. Clinical validations show that lung and testicular cancers exhibit distinct fingerprints detectable from only 250 RNA reads within 4 hours, significantly reducing diagnostic time and cost. The integration of this technology with liquid biopsies could revolutionize non-invasive cancer screening, particularly for high-risk populations. Future standardization of epitranscriptomic fingerprint databases may enable global implementation of precision oncology protocols within the next decade.