Singhto Nilubon, Pongphitcha Pongpak, Jinawath Natini, Hongeng Suradej, Chutipongtanate Somchai
Ramathibodi Comprehensive Cancer Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Bangkok Child Health Center, Bangkok Hospital Headquarters, Bangkok 10130, Thailand.
Cancers (Basel). 2024 Apr 26;16(9):1681. doi: 10.3390/cancers16091681.
Liquid biopsy involves the utilization of minimally invasive or noninvasive techniques to detect biomarkers in biofluids for disease diagnosis, monitoring, or guiding treatments. This approach is promising for the early diagnosis of childhood cancer, especially for brain tumors, where tissue biopsies are more challenging and cause late detection. Extracellular vesicles offer several characteristics that make them ideal resources for childhood cancer liquid biopsy. Extracellular vesicles are nanosized particles, primarily secreted by all cell types into body fluids such as blood and urine, and contain molecular cargos, i.e., lipids, proteins, and nucleic acids of original cells. Notably, the lipid bilayer-enclosed structure of extracellular vesicles protects their cargos from enzymatic degradation in the extracellular milieu. Proteins and nucleic acids of extracellular vesicles represent genetic alterations and molecular profiles of childhood cancer, thus serving as promising resources for precision medicine in cancer diagnosis, treatment monitoring, and prognosis prediction. This review evaluates the recent progress of extracellular vesicles as a liquid biopsy platform for various types of childhood cancer, discusses the mechanistic roles of molecular cargos in carcinogenesis and metastasis, and provides perspectives on extracellular vesicle-guided therapeutic intervention. Extracellular vesicle-based liquid biopsy for childhood cancer may ultimately contribute to improving patient outcomes.
液体活检涉及利用微创或无创技术检测生物流体中的生物标志物，用于疾病诊断、监测或指导治疗。这种方法对于儿童癌症的早期诊断很有前景，特别是对于脑肿瘤，因为组织活检更具挑战性且会导致检测延迟。细胞外囊泡具有几个特性，使其成为儿童癌症液体活检的理想资源。细胞外囊泡是纳米级颗粒，主要由所有细胞类型分泌到血液和尿液等体液中，并包含分子货物，即原始细胞的脂质、蛋白质和核酸。值得注意的是，细胞外囊泡的脂质双层封闭结构保护其货物在细胞外环境中免受酶降解。细胞外囊泡的蛋白质和核酸代表儿童癌症的基因改变和分子特征，因此作为癌症诊断、治疗监测和预后预测的精准医学的有前景资源。本综述评估了细胞外囊泡作为各种儿童癌症液体活检平台的最新进展，讨论了分子货物在致癌作用和转移中的机制作用，并提供了细胞外囊泡指导的治疗干预的观点。基于细胞外囊泡的儿童癌症液体活检最终可能有助于改善患者预后。
