Almasry Yazan, Mustafa Fayrouz, Alfuwais Mohammed, AlNachef Sara, Mohamed Hager, Gaber Nusaibah S, Khan Mohammed Imran, Saadeldin Islam M, Yaqinuddin Ahmed
College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Research Center, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia.
Front Oncol. 2025 Jun 3;15:1592006. doi: 10.3389/fonc.2025.1592006. eCollection 2025.
Extracellular vesicles (EVs) play an integral role in cancer biology, influencing tumor progression, metastasis, and tumor microenvironment. Due to their distinctive molecular composition, including proteins, nucleic acids, and lipids, EVs present a promising candidate for cancer diagnostics and precision therapeutics.
This review was conducted by looking up recent studies obtained through PubMed, Scopus, and Web of Science databases using targeted keywords such as "Extracellular Vesicles," "Cancer Therapy," "Biomarkers," "Exosomes," "Tumor Microenvironment," and "Precision Medicine." From an initial 4,320 articles identified, 427 were screened after applying publication filters, resulting in the inclusion of 298 articles relevant to EV isolation, characterization, diagnostic sensitivity, specificity, and therapeutic efficacy.
Biomarkers derived from EVs derived across various cancers showed high diagnostic performance. For example, four miRNA EVs showing sensitivity and specificity of 98% and 96% respectively was found in breast cancer. EV-RNA and surface antigen analyses for hepatocellular carcinoma with 93.8% sensitivity and 74.5% specificity. Additionally, EV biomarker cancers of the colorectal microRNA miR-23a and miR-301a had 89% sensitivity and >70% specificity. EVs in a therapeutic context were an effective drug delivery system for enhancing precision of chemotherapy and immunotherapy with reduced systemic toxicity.
The theranostics of EVs provide great capacity for early cancer diagnosis and personalized treatment based on their high diagnostic sensitivity and specificity. Future standardization protocols are essential to translate EV technologies into clinical oncology.
细胞外囊泡（EVs）在癌症生物学中发挥着不可或缺的作用，影响肿瘤进展、转移和肿瘤微环境。由于其独特的分子组成，包括蛋白质、核酸和脂质，EVs是癌症诊断和精准治疗的一个有前景的候选者。
本综述通过使用“细胞外囊泡”、“癌症治疗”、“生物标志物”、“外泌体”、“肿瘤微环境”和“精准医学”等目标关键词，在PubMed、Scopus和Web of Science数据库中查找近期研究。从最初识别出的4320篇文章中，应用发表筛选标准后筛选出427篇，最终纳入298篇与EV分离、表征、诊断敏感性、特异性和治疗效果相关的文章。
来自各种癌症的EV衍生生物标志物显示出高诊断性能。例如，在乳腺癌中发现四种miRNA EV的敏感性和特异性分别为98%和96%。肝细胞癌的EV-RNA和表面抗原分析的敏感性为93.8%，特异性为74.5%。此外，结直肠癌的EV生物标志物microRNA miR-23a和miR-301a的敏感性为89%，特异性>70%。在治疗方面，EV是一种有效的药物递送系统，可提高化疗和免疫治疗的精准度并降低全身毒性。
基于其高诊断敏感性和特异性，EV的诊疗为早期癌症诊断和个性化治疗提供了巨大潜力。未来的标准化方案对于将EV技术转化为临床肿瘤学至关重要。
