Hussain Md Sadique, Moglad Ehssan, Goyal Ahsas, Rekha M M, Sharma Girish Chandra, Jayabalan Karthikeyan, Sahoo Samir, Devi Anita, Goyal Kavita, Gupta Gaurav, Shahwan Moyad, Alzarea Sami I, Kazmi Imran
Uttaranchal Institute of Pharmaceutical Sciences, Uttaranchal University, Dehradun, India.
Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, P.O. Box 173, Alkharj 11942, Saudi Arabia.
Clin Chim Acta. 2025 Jun 1;573:120307. doi: 10.1016/j.cca.2025.120307. Epub 2025 Apr 12.
Non-invasive diagnostic monitoring techniques have become essential for treating lung cancer (LC), which continues to be the primary cause of cancer-related death worldwide. The new diagnostic biomarkers called tumour-educated platelets (TEPs) show strong prospects for providing vital information about tumor biology, tumor spread pathways, and treatment reaction patterns. Despite lacking a nucleus, platelets exhibit an active RNA profile that develops through interactions with tumor-derived compounds and the tumor microenvironments (TME). This review explains platelet-tumour interaction regulatory mechanisms while focusing on platelet contributions toward cancer development, immune system avoidance, and blood clot formation. The detection and classification of LC show promise through the analysis of RNA molecules extracted from platelets that encompass mRNAs and non-coding RNAs. RNA sequencing technology based on TEP demonstrates excellent diagnostic power by correctly identifying LC patients alongside their oncogenic alterations of EGFR, KRAS, and ALK. Treatment predictions have proven successful using platelet RNA profiles, specifically in immunotherapy and targeted therapy. Integrating next-generation sequencing with machine learning and artificial intelligence enhances TEP-based diagnostic tools, improving detection accuracy. Standardizing platelet extraction methods and vesicle purification from tumor material needs better development for effective and affordable clinical use. Future investigations should combine TEPs with circulating tumor DNA and exosomal RNA markers to enhance both earliest-stage LC diagnosis and patient-specific therapeutic approaches. TEPs introduce a groundbreaking technique in oncology since they can transform non-invasive medical diagnostics and therapeutic monitoring for cancer.
非侵入性诊断监测技术已成为治疗肺癌（LC）的关键，肺癌仍是全球癌症相关死亡的主要原因。一种名为肿瘤驯化血小板（TEP）的新型诊断生物标志物在提供有关肿瘤生物学、肿瘤扩散途径和治疗反应模式的重要信息方面显示出强大的前景。尽管血小板没有细胞核，但它具有活跃的RNA谱，这种RNA谱通过与肿瘤衍生化合物和肿瘤微环境（TME）的相互作用而形成。本综述解释了血小板与肿瘤相互作用的调节机制，重点关注血小板在癌症发展、逃避免疫系统和形成血栓方面的作用。通过分析从血小板中提取的包含mRNA和非编码RNA的RNA分子，肺癌的检测和分类显示出前景。基于TEP的RNA测序技术通过正确识别肺癌患者及其EGFR、KRAS和ALK的致癌改变，显示出优异的诊断能力。使用血小板RNA谱进行治疗预测已被证明是成功的，特别是在免疫治疗和靶向治疗方面。将下一代测序与机器学习和人工智能相结合可增强基于TEP的诊断工具，提高检测准确性。为了实现有效且经济的临床应用，需要进一步改进从肿瘤材料中提取血小板和纯化囊泡的方法。未来的研究应将TEP与循环肿瘤DNA和外泌体RNA标志物相结合，以加强早期肺癌诊断和针对患者的治疗方法。TEP在肿瘤学中引入了一种开创性技术，因为它们可以改变癌症的非侵入性医学诊断和治疗监测。
