Zhang Yuan, Yue Ning-Ning, Chen Li-Yu, Tian Cheng-Mei, Yao Jun, Wang Li-Sheng, Liang Yu-Jie, Wei Dao-Ru, Ma Hua-Lin, Li De-Feng
Department of Gastroenterology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518000, Guangdong Province, China.
Department of Medical Administration, Huizhou Institute for Occupational Health, Huizhou 516000, Guangdong Province, China.
World J Gastrointest Oncol. 2025 Apr 15;17(4):103591. doi: 10.4251/wjgo.v17.i4.103591.
Gastrointestinal (GI) cancers, which predominantly manifest in the stomach, colorectum, liver, esophagus, and pancreas, accounting for approximately 35% of global cancer-related mortality. The advent of liquid biopsy has introduced a pivotal diagnostic modality for the early identification of premalignant GI lesions and incipient cancers. This non-invasive technique not only facilitates prompt therapeutic intervention, but also serves as a critical adjunct in prognosticating the likelihood of tumor recurrence. The wealth of circulating exosomes present in body fluids is often enriched with proteins, lipids, microRNAs, and other RNAs derived from tumor cells. These specific cargo components are reflective of processes involved in GI tumorigenesis, tumor progression, and response to treatment. As such, they represent a group of promising biomarkers for aiding in the diagnosis of GI cancer. In this review, we delivered an exhaustive overview of the composition of exosomes and the pathways for cargo sorting within these vesicles. We laid out some of the clinical evidence that supported the utilization of exosomes as diagnostic biomarkers for GI cancers and discussed their potential for clinical application. Furthermore, we addressed the challenges encountered when harnessing exosomes as diagnostic and predictive instruments in the realm of GI cancers.
胃肠道（GI）癌症主要发生在胃、结肠直肠、肝脏、食管和胰腺，约占全球癌症相关死亡率的35%。液体活检的出现为早期识别癌前胃肠道病变和早期癌症引入了一种关键的诊断方式。这种非侵入性技术不仅有助于及时进行治疗干预，还在预测肿瘤复发可能性方面起到关键辅助作用。体液中存在的大量循环外泌体通常富含来自肿瘤细胞的蛋白质、脂质、微小RNA和其他RNA。这些特定的货物成分反映了胃肠道肿瘤发生、肿瘤进展和对治疗反应所涉及的过程。因此，它们代表了一组有前景的生物标志物，有助于胃肠道癌症的诊断。在这篇综述中，我们详尽概述了外泌体的组成以及这些囊泡内货物分选的途径。我们列出了一些支持将外泌体用作胃肠道癌症诊断生物标志物的临床证据，并讨论了它们的临床应用潜力。此外，我们还探讨了在胃肠道癌症领域将外泌体用作诊断和预测工具时遇到的挑战。
