Datta Brateen, Paul Debashish, Dey Tina, Pal Suchetan, Rakshit Tatini
School of Medical Science and Technology, IIT Kharagpur, West Bengal 721302, India.
Department of Chemical, Biological & Macromolecular Sciences, S. N. Bose National Centre for Basic Sciences, Salt Lake City, Kolkata 700106, India.
ACS Bio Med Chem Au. 2022 Mar 1;2(3):222-235. doi: 10.1021/acsbiomedchemau.1c00043. eCollection 2022 Jun 15.
Colorectal cancer typically begins from a nonmalignant polyp formation in the large intestine that, over time, develops into colorectal cancer. The growth of benign polyps can be checked if detected in the early stages of the disease. Doctors usually recommend colonoscopy to average and high-risk individuals for colorectal cancer screening. Elevated carcinoembryonic antigen (CEA) is a broadly used biomarker for colorectal cancer. The genetic and epigenetic alteration of genes such as p53, BRAF, APC, and PIK3CA is also correlated with colorectal cancer in various clinical studies. In general, tissue biopsy is most frequently used for colorectal cancer diagnosis, but the whole tumor heterogeneity cannot be accessed by this technique. Furthermore, such a highly invasive technique is not suitable for repeated testing. Recently, extracellular vesicles (EVs), lipid bilayer enclosed sacs secreted from colorectal cancer cells, are emerging as a diagnostic tool for colon cancer detection. The major advantages of using EVs for colon cancer diagnosis are (i) EVs can be isolated in a noninvasive manner from the body fluid and (ii) EV incorporated cargoes (mostly RNAs) reveal various aspects of colorectal cancer. EV-RNAs are also implicated in tumor invasion and influence the immune system for the further spread of tumors. However, due to the lack of standardized EV detection strategies, diagnostic applicability is limited. Herein, we review the recent literature on the pathobiological dependence of colorectal cancer on EV-RNAs. Further, we present the advantages of identification and characterization of EV-RNAs to explore the connection between differential expression of extracellular vesicle incorporated RNAs and colorectal cancer. How this approach may potentially translate into point of care colorectal cancer diagnostics is also discussed.
结直肠癌通常始于大肠中的非恶性息肉形成，随着时间的推移，这些息肉会发展成结直肠癌。如果在疾病的早期阶段检测到良性息肉的生长，就可以对其进行检查。医生通常建议平均风险和高风险个体进行结肠镜检查以筛查结直肠癌。癌胚抗原（CEA）升高是一种广泛用于结直肠癌的生物标志物。在各种临床研究中，p53、BRAF、APC和PIK3CA等基因的遗传和表观遗传改变也与结直肠癌相关。一般来说，组织活检最常用于结直肠癌的诊断，但这种技术无法获取整个肿瘤的异质性。此外，这种侵入性很强的技术不适合重复检测。最近，细胞外囊泡（EVs），即结直肠癌细胞分泌的包裹在脂质双层中的囊泡，正成为一种用于检测结肠癌的诊断工具。使用EVs进行结肠癌诊断的主要优点是：（i）EVs可以通过非侵入性方式从体液中分离出来；（ii）EVs所含的物质（主要是RNA）揭示了结直肠癌的各个方面。EV-RNAs也与肿瘤侵袭有关，并影响免疫系统以促进肿瘤的进一步扩散。然而，由于缺乏标准化的EV检测策略，其诊断适用性受到限制。在此，我们综述了关于结直肠癌对EV-RNAs的病理生物学依赖性的最新文献。此外，我们阐述了鉴定和表征EV-RNAs的优势，以探索细胞外囊泡所含RNA的差异表达与结直肠癌之间的联系。还讨论了这种方法如何可能转化为即时护理结直肠癌诊断。
