Department of Urology and Pediatric Urology, Saarland University, Homburg/Saar, Germany.
Nat Rev Urol. 2020 Jan;17(1):11-27. doi: 10.1038/s41585-019-0261-8. Epub 2019 Dec 11.
Extracellular vesicles (EVs) have an essential functional role in local tumour progression, metastatic spread and the emergence of drug resistance in bladder, kidney and prostate cancer. Thus, EVs could be diagnostic, prognostic and predictive biomarkers for these malignancies. Virtually all biomolecules (including DNA, mRNA, microRNA, long non-coding RNA, proteins and lipids) packaged into EVs have been tested as biomarkers in blood and urine samples. The results are very heterogeneous, but promising biomarker candidates have been identified. Differing methods of EV isolation, characterization and analysis of their content have been used owing to a lack of international consensus; hence, comparing study results is challenging. Furthermore, validation of potential biomarkers in independent cohorts or prospective trials has rarely been performed. Future efforts to establish EV-derived biomarkers need to adequately address these points. In addition, emerging technologies such as mass spectroscopy and chip-based approaches can identify surface markers specific for cancer-associated EVs and will enable specific separation from blood and urine EVs, which probably will improve their performance as biomarkers. Moreover, EVs could be harnessed as therapeutic drug delivery vehicles for precise and effective anticancer therapy.
细胞外囊泡 (EVs) 在膀胱癌、肾癌和前列腺癌的局部肿瘤进展、转移扩散和耐药性的出现中具有重要的功能作用。因此，EVs 可以作为这些恶性肿瘤的诊断、预后和预测生物标志物。几乎所有被包裹在 EVs 中的生物分子（包括 DNA、mRNA、microRNA、长非编码 RNA、蛋白质和脂质）都已在血液和尿液样本中作为生物标志物进行了测试。结果非常不一致，但已经确定了有前途的生物标志物候选物。由于缺乏国际共识，因此使用了不同的 EV 分离方法、表征方法和分析其内容的方法；因此，比较研究结果具有挑战性。此外，很少在独立队列或前瞻性试验中对潜在生物标志物进行验证。未来建立 EV 衍生生物标志物的工作需要充分解决这些问题。此外，质谱和基于芯片的新兴技术可以识别与癌症相关的 EV 的特异性表面标志物，并能够从血液和尿液 EV 中进行特异性分离，这可能会提高它们作为生物标志物的性能。此外，EVs 可以被利用为治疗性药物输送载体，用于精确和有效的抗癌治疗。
