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外泌体:引领非侵入性癌症诊断的创新生物标志物。

Exosomes: innovative biomarkers leading the charge in non-invasive cancer diagnostics.

作者信息

Li Jiale, Wang Ailin, Guo Haijun, Zheng Wei, Chen Rui, Miao Changfeng, Zheng Dandan, Peng Jun, Wang Jiachong, Chen Zigui

机构信息

Department of Neurosurgery, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou, China, 570208.

School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China, 211198.

出版信息

Theranostics. 2025 Apr 13;15(11):5277-5311. doi: 10.7150/thno.113650. eCollection 2025.

DOI:10.7150/thno.113650
PMID:40303340
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12036879/
Abstract

Exosomes, nanoscale extracellular vesicles secreted by diverse cell types, have emerged as promising biomarkers for non-invasive tumor diagnostics, offering significant advantages over traditional methods. These vesicles, typically ranging from 30 to 150 nanometers in size, carry a diverse cargo of proteins, lipids, RNA, and microRNAs, which reflect the molecular alterations occurring within their parent cells. Notably, exosomes can be isolated from easily accessible biofluids such as blood, urine, and saliva, making them ideal candidates for liquid biopsy applications. This review explores the transformative potential of exosome-based biomarkers in the early detection and monitoring of cancers across diverse organ systems, including respiratory, digestive, hematological, neurological, endocrine malignancies and so on. Special emphasis is placed on their application in clinical trials, where exosome-based diagnostics have demonstrated promising results in detecting tumors at early stages and monitoring treatment responses, offering a less invasive and more accessible alternative to traditional biopsies. While recent advancements in exosome isolation and characterization technologies have significantly improved the sensitivity and specificity of these diagnostics, challenges such as biological heterogeneity, lack of standardization, and regulatory hurdles remain. Nevertheless, exosome-based diagnostics hold the promise of providing real-time, dynamic insights into tumor progression, enhancing personalized medicine. The integration of exosomes into clinical practice could revolutionize cancer diagnostics and therapy, improving patient outcomes. Further research and large-scale clinical validation are essential to fully realize the clinical potential of exosome-based biomarker applications in routine clinical settings.

摘要

外泌体是由多种细胞类型分泌的纳米级细胞外囊泡,已成为非侵入性肿瘤诊断中有前景的生物标志物,比传统方法具有显著优势。这些囊泡通常大小在30到150纳米之间,携带多种蛋白质、脂质、RNA和微小RNA,反映了其母细胞内发生的分子变化。值得注意的是,外泌体可以从血液、尿液和唾液等易于获取的生物流体中分离出来,使其成为液体活检应用的理想候选者。本文综述探讨了基于外泌体的生物标志物在跨多种器官系统的癌症早期检测和监测中的变革潜力,包括呼吸道、消化系统、血液系统、神经系统、内分泌系统恶性肿瘤等。特别强调了它们在临床试验中的应用,基于外泌体的诊断在早期检测肿瘤和监测治疗反应方面已显示出有前景的结果,为传统活检提供了一种侵入性较小且更易获取的替代方法。虽然外泌体分离和表征技术的最新进展显著提高了这些诊断的灵敏度和特异性,但生物异质性、缺乏标准化和监管障碍等挑战仍然存在。尽管如此,基于外泌体的诊断有望提供肿瘤进展的实时、动态见解,增强个性化医疗。将外泌体整合到临床实践中可能会彻底改变癌症诊断和治疗,改善患者预后。进一步的研究和大规模临床验证对于在常规临床环境中充分实现基于外泌体的生物标志物应用的临床潜力至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0ae/12036879/0b98a1f5848a/thnov15p5277g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0ae/12036879/695559603758/thnov15p5277g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0ae/12036879/5d7518a65de4/thnov15p5277g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0ae/12036879/975645f89acc/thnov15p5277g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0ae/12036879/ea34dc657482/thnov15p5277g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0ae/12036879/0b98a1f5848a/thnov15p5277g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0ae/12036879/695559603758/thnov15p5277g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0ae/12036879/5d7518a65de4/thnov15p5277g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0ae/12036879/975645f89acc/thnov15p5277g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0ae/12036879/ea34dc657482/thnov15p5277g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0ae/12036879/0b98a1f5848a/thnov15p5277g005.jpg

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本文引用的文献

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J Nanobiotechnology. 2025 Mar 21;23(1):232. doi: 10.1186/s12951-025-03306-0.
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Mesenchymal Stem Cell-Derived Exosomes in Cancer Resistance Against Therapeutics.间充质干细胞来源的外泌体在癌症抗治疗性中的作用
Cancers (Basel). 2025 Feb 27;17(5):831. doi: 10.3390/cancers17050831.
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Identification of blood-derived exosomal tumor RNA signatures as noninvasive diagnostic biomarkers for multi-cancer: a multi-phase, multi-center study.
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World J Gastroenterol. 2025 Jul 14;31(26):109500. doi: 10.3748/wjg.v31.i26.109500.
鉴定血液来源的外泌体肿瘤RNA特征作为多种癌症的非侵入性诊断生物标志物:一项多阶段、多中心研究。
Mol Cancer. 2025 Mar 1;24(1):60. doi: 10.1186/s12943-025-02271-4.
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Fully Integrated Centrifugal Microfluidics for Rapid Exosome Isolation, Glycan Analysis, and Point-of-Care Diagnosis.用于快速外泌体分离、聚糖分析和即时诊断的全集成离心微流控技术。
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