Abstract:Hepatocellular carcinoma (HCC) is the most prevalent pathological type of primary liver cancer, accounting for 75% to 85% of all liver cancer cases. The occurrence and development of HCC are closely associated with the regulatory functions of both coding RNAs and non-coding RNAs. Circular RNAs (circRNAs) represent a novel class of endogenous non-coding RNA. CircRNAs are covalently closed-loop RNA formed by back-splicing of precursor mRNAs. Compared to linear RNAs, circRNAs lack the 5'-end cap and 3'-end poly A tail structure but can regulate gene expression in mammals. CircRNAs are structurally conserved and stable and have a higher tolerance to exonucleases. In HCC, circRNAs have been demonstrated to regulate tumor cell proliferation, migration, invasion, and resistance to cell death. Their roles in regulating angiogenesis, genomic instability, immune surveillance, and metabolic reprogramming are also becoming evident. However, the detailed mechanisms involving circRNAs in HCC remain elusive, especially regarding how circRNAs regulate angiogenesis in HCC, modulate the evasion of HCC cells from the detection and attack of the immune cells, and regulate cellular energy metabolism to provide energy for HCC cell proliferation, invasion, and metastasis. Studying circRNAs that play critical regulatory roles in HCC may hold promise for targeted therapies, thereby enhancing treatment effectiveness and improving patient prognosis. In this review, the authors summarize the abnormal expression of circRNAs in HCC and their regulatory roles in angiogenesis, immune cell interactions, and energy metabolism for HCC cells.