Zhang Haodong, Wu Bohan, Zhou Tingting, Fang Liaoqiong
College of Sericulture, Textile and Biomass Sciences, Southwest University, Beibei, Chongqing, China.
Westa College, Southwest University, Beibei, Chongqing, China.
Clin Transl Oncol. 2025 Apr 9. doi: 10.1007/s12094-025-03915-z.
Extracellular vesicles (EVs) are prognostic factors in colorectal cancer (CRC). This study aims to evaluate the prognostic value of EVs CRC.
Clinical studies that directly investigated the association between EVs in different kinds of body fluids of CRC patients and patient prognosis were included by searching the PubMed, Web of Science, ClinicalTrials, and CENTRAL databases. The associations between single biomarkers, molecular panels, and EVs count with overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) were analyzed. Heterogeneity was assessed using the I statistic, with a random-effects model applied when I > 30% and a fixed-effects model when I ≤ 30%.
A total of 56 studies involving 5,985 patients were included. All included studies detected EVs in blood. Univariate analysis revealed an association between EVs single-biomarkers and OS (pHR = 2.07, 95% CI: 1.73-2.73) and DFS (pHR = 2.20, 95% CI: 1.46-2.79). Additionally, univariate analysis revealed an association between molecular-panels in EVs and OS (pHR = 3.67, 95% CI: 2.51-5.36) and RFS (pHR = 3.97, 95% CI: 1.57-10.08). Moreover, an association was observed between a EVs count and OS (pHR = 1.87, 95% CI: 1.40-2.49). On the basis of the results of the meta-regression and subgroup analyses, the subgroups of EVs and the disease stage of CRC patients are key factors contributing to the heterogeneity in the associations between EVs single-biomarkers and OS.
This study provides compelling evidence that EVs from blood hold prognostic value in CRC.
细胞外囊泡（EVs）是结直肠癌（CRC）的预后因素。本研究旨在评估EVs对CRC的预后价值。
通过检索PubMed、Web of Science、ClinicalTrials和CENTRAL数据库，纳入直接研究CRC患者不同体液中EVs与患者预后之间关联的临床研究。分析单个生物标志物、分子面板和EVs计数与总生存期（OS）、无病生存期（DFS）和无复发生存期（RFS）之间的关联。使用I统计量评估异质性，当I>30%时应用随机效应模型，当I≤30%时应用固定效应模型。
共纳入56项研究，涉及5985例患者。所有纳入研究均在血液中检测到EVs。单因素分析显示，EVs单个生物标志物与OS（风险比=2.07，95%置信区间：1.73-2.73）和DFS（风险比=2.20，95%置信区间：1.46-2.79）之间存在关联。此外，单因素分析显示，EVs中的分子面板与OS（风险比=3.67，95%置信区间：2.51-5.36）和RFS（风险比=3.97，95%置信区间：1.57-10.08）之间存在关联。此外，还观察到EVs计数与OS之间存在关联（风险比=1.87，95%置信区间：1.40-2.49）。基于meta回归和亚组分析结果，EVs亚组和CRC患者的疾病分期是导致EVs单个生物标志物与OS之间关联异质性的关键因素。
本研究提供了有力证据，表明血液中的EVs对CRC具有预后价值。
