Liu Haibo, Zhu Lei, Yin Jianmei
Emergency Department, The First Hospital of Jilin University, Changchun, Jilin, China.
Department of Otolaryngology-Head and Neck Surgery, The First Hospital of Jilin University, Changchun, Jilin, China.
Front Immunol. 2025 Jul 23;16:1595124. doi: 10.3389/fimmu.2025.1595124. eCollection 2025.
Gastric cancer (GC) ranks among the most prevalent forms of cancer and contributes significantly to cancer-related mortality. There exists a pressing need to investigate novel approaches for GC management to improve diagnostic methods, therapeutic interventions, and patient outcomes. Exosomes are nanoscale extracellular vesicles (EVs) derived from various cell types that carry a diverse range of biomolecular cargo, including DNA, RNA, proteins, lipids, and other bioactive constituents. They play significant roles in GC pathogenesis and tumor microenvironment (TME) modulation. Exosomes derived from cancer cells can enhance tumor progression, transform the TME, and modulate immune responses. Immune cell-derived exosomes can similarly modulate immune functions and the TME. Immunotherapy represents a GC treatment breakthrough and is expected to show efficacy when combined with exosome-targeted therapy. Abundant research has demonstrated that exosomes are crucial for tumor growth, immune evasion, immune microenvironment reconfiguration, and immunotherapy efficacy in GC. This review describes the role of exosomes in the GC microenvironment, focusing on the mechanisms by which exosomes regulate immune responses to GC, and summarizes the current status of and challenges in the development of exosome-based diagnostics and immunotherapy for GC.
胃癌（GC）是最常见的癌症形式之一，在癌症相关死亡率中占很大比例。迫切需要研究新的胃癌管理方法，以改进诊断方法、治疗干预措施和患者预后。外泌体是源自各种细胞类型的纳米级细胞外囊泡（EVs），携带多种生物分子货物，包括DNA、RNA、蛋白质、脂质和其他生物活性成分。它们在胃癌发病机制和肿瘤微环境（TME）调节中发挥重要作用。癌细胞衍生的外泌体可促进肿瘤进展、改变TME并调节免疫反应。免疫细胞衍生的外泌体同样可以调节免疫功能和TME。免疫疗法是胃癌治疗的一项突破，与外泌体靶向疗法联合使用有望显示出疗效。大量研究表明，外泌体在胃癌的肿瘤生长、免疫逃逸、免疫微环境重塑和免疫治疗疗效方面至关重要。本综述描述了外泌体在胃癌微环境中的作用，重点关注外泌体调节对胃癌免疫反应的机制，并总结了基于外泌体的胃癌诊断和免疫治疗的发展现状及挑战。
