The function of NAT10-driven N4-acetylcytidine modification in cancer: novel insights and potential therapeutic targets

N4-acetylcytidine (ac4C) is a novel RNA modification that plays important biological roles in a variety of diseases, including tumors, by regulating gene expression at the posttranscriptional level. As a currently known ac4C-modified "writing" protein, N-acetyltransferase (NAT10) affects the stability and translation efficiency of target mRNAs by changing the chemical and spatial structure of RNA, thereby acting as an oncogene and tumor suppressor gene in different tumors, highlighting its potential role as a tumor prognostic marker and therapeutic target. Research on the molecular mechanism of ac4C modification and its function in tumors continues to expand, but its action network and clinical translational application still face many challenges. This review systematically explains the molecular mechanism of ac4C modification and its biological significance in tumors and its connection with relevant signaling pathways and the immune microenvironment, focuses on analyzing the research progress of ac4C modification enzymes, and discusses its potential as a tumor target. The purpose of this study was to provide a theoretical basis and new ideas for basic research and the clinical translation of the ac4C modification in the field of oncology.