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细胞外囊泡作为新型尿路上皮肿瘤生物标志物:临床应用见解

Extracellular vesicles as novel uro-oncology biomarkers: insights toward clinical applications.

作者信息

Urabe Fumihiko, Tamura Takaaki, Sakamoto Shinichi, Kimura Takahiro, Ochiya Takahiro

机构信息

Department of Urology, The Jikei University School of Medicine, Tokyo.

Department of Urology, Chiba University, Chiba.

出版信息

Curr Opin Urol. 2025 Jan 1;35(1):13-18. doi: 10.1097/MOU.0000000000001194. Epub 2024 Jun 4.

Abstract

PURPOSE OF REVIEW

We discussed the challenges associated with the clinical application of extracellular vesicles and summarized their potential impact on oncological clinical practice in urology.

RECENT FINDINGS

Despite extensive research on extracellular vesicles, their clinical applications remain limited; this is likely to be because of small study cohorts, a lack of large-scale analyses, and the impact of variable extraction and storage methods on analysis outcomes. However, promising results have emerged from clinical trials targeting urinary extracellular vesicles in prostate cancer using ExoDx Prostate Test. The ExoDx Prostate Test has demonstrated its efficacy in diagnosing prostate cancer in previous studies and is the only FDA-approved kit for this purpose. Moreover, recent trials have investigated the use of the ExoDx Prostate Test to determine the optimal timing for biopsies in prostate cancer patients undergoing active surveillance.

SUMMARY

We summarized recent studies on the potential of extracellular vesicles in the management of urological cancers. Particularly, the diagnosis of prostate cancer using the ExoDx Prostate Test has yielded positive results in several clinical trials. Additionally, while there are other studies suggesting its efficacy, most of these are based on retrospective analyses. These findings warrant further large-scale studies to optimize extracellular vesicle-based diagnostic and monitoring strategies. Although further research is required, extracellular vesicles would be attractive for early detection and surveillance.

摘要

综述目的

我们讨论了细胞外囊泡临床应用中面临的挑战,并总结了它们对泌尿外科肿瘤临床实践的潜在影响。

最新研究发现

尽管对细胞外囊泡进行了广泛研究,但其临床应用仍然有限;这可能是由于研究队列规模小、缺乏大规模分析以及可变的提取和储存方法对分析结果的影响。然而,使用ExoDx前列腺检测针对前列腺癌尿液细胞外囊泡的临床试验已取得了有前景的结果。ExoDx前列腺检测在先前研究中已证明其在诊断前列腺癌方面的有效性,并且是唯一获得美国食品药品监督管理局批准用于此目的的试剂盒。此外,最近的试验研究了使用ExoDx前列腺检测来确定接受主动监测的前列腺癌患者活检的最佳时机。

总结

我们总结了近期关于细胞外囊泡在泌尿生殖系统癌症管理中的潜力的研究。特别是,使用ExoDx前列腺检测诊断前列腺癌在多项临床试验中取得了积极结果。此外,虽然有其他研究表明其有效性,但其中大多数基于回顾性分析。这些发现需要进一步的大规模研究,以优化基于细胞外囊泡的诊断和监测策略。尽管还需要进一步研究,但细胞外囊泡对于早期检测和监测将具有吸引力。

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