Chen Kai, Wang Qi, Kornmann Marko, Tian Xiaodong, Yang Yinmo
Department of General Surgery, Peking University First Hospital, Beijing, China.
Clinic of General, Visceral and Transplantation Surgery, University of Ulm, Ulm, Germany.
Front Oncol. 2021 Feb 26;11:644358. doi: 10.3389/fonc.2021.644358. eCollection 2021.
Pancreatic ductal adenocarcinoma (PDAC) remains one of the most dismal gastrointestinal malignancies with an overall 5-year survival rate of 8%-9%. The intra-tumor heterogeneity and special tumor microenvironment in PDAC make it challenging to develop effective treatment strategies. Exosomes are extracellular vesicles that originate from the endosomes and have a diameter of 40-160 nm. A growing body of evidence has shown that exosomes play vital roles in tumor initiation and development. Recently, extensive application of exosomes as biomarkers and drug carriers has rendered them attractive in the field of PDAC. This review summarizes the latest progress in the methodologies for isolation, modification, and tracking of exosomes, exosome-mediated cell-to-cell communication, clinical applications of exosome as minimally invasive liquid biopsy and drugs carriers, as well as their involvement in the angiogenic regulation in PDAC. In spite of these advancements, some obstacles are still required to be overcome to use the exosome-based technologies for early diagnosis or improvement of prognosis of patients with PDAC.
胰腺导管腺癌（PDAC）仍然是最凶险的胃肠道恶性肿瘤之一，总体5年生存率为8%-9%。PDAC中的肿瘤内异质性和特殊的肿瘤微环境使得制定有效的治疗策略具有挑战性。外泌体是源自内体的细胞外囊泡，直径为40-160纳米。越来越多的证据表明，外泌体在肿瘤的发生和发展中起着至关重要的作用。最近，外泌体作为生物标志物和药物载体的广泛应用使其在PDAC领域具有吸引力。本文综述了外泌体分离、修饰和追踪方法、外泌体介导的细胞间通讯、外泌体作为微创液体活检和药物载体的临床应用以及它们在PDAC血管生成调节中的最新进展。尽管取得了这些进展，但要将基于外泌体的技术用于PDAC患者的早期诊断或改善预后，仍需克服一些障碍。
