Arora Ankita, Sharma Vinit, Kaushal Anikait, Aggarwal Anjali
Department of Anatomy, Post Graduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, India.
Clin Transl Oncol. 2025 Sep 12. doi: 10.1007/s12094-025-04055-0.
Gastrointestinal (GI) cancers represent a significant global health burden, accounting for over one-third of cancer-related deaths globally. Regardless of advancements in treatment procedures, the high mortality rate underscores the crucial need for novel diagnostic biomarkers and therapeutic strategies. Extracellular vesicles (EVs) appeared as fundamental facilitators of intercellular interaction, influencing gene expression as well as cellular function through the transfer of nucleic acids, proteins, and lipids. EVs play dual roles in maintaining intestinal homeostasis under physiological conditions and driving tumorigenesis in pathological states. In GI cancers, EVs contribute to tumor progression by modulating the tumor microenvironment (TME), promoting angiogenesis, epithelial-to-mesenchymal transition (EMT), immune evasion, and metastasis. Moreover, EVs portray a vital role in creating pre-metastatic site, reprogramming immune cells, and facilitating therapeutic resistance through the transfer of resistance-associated molecules. The clinical potential of EVs extends to their utility as liquid biopsy biomarkers, offering a non-invasive approach for early diagnosis, prognostication, and treatment monitoring. EV-miRNAs and EV-long non-coding RNAs demonstrate significant diagnostic and prognostic value in GI cancers. This review provides a widespread impression of the biogenesis, molecular properties, and functional roles of EVs in GI cancers, with a focus on their clinical utility.
胃肠道（GI）癌症是全球重大的健康负担，占全球癌症相关死亡人数的三分之一以上。尽管治疗方法有所进步，但高死亡率凸显了对新型诊断生物标志物和治疗策略的迫切需求。细胞外囊泡（EVs）作为细胞间相互作用的基本促进者出现，通过核酸、蛋白质和脂质的转移影响基因表达以及细胞功能。EVs在生理条件下维持肠道稳态和在病理状态下驱动肿瘤发生中发挥双重作用。在胃肠道癌症中，EVs通过调节肿瘤微环境（TME）、促进血管生成、上皮-间质转化（EMT）、免疫逃逸和转移来促进肿瘤进展。此外，EVs在创建转移前位点、重编程免疫细胞以及通过转移抗性相关分子促进治疗抗性方面发挥重要作用。EVs的临床潜力扩展到其作为液体活检生物标志物的效用，为早期诊断、预后评估和治疗监测提供了一种非侵入性方法。EV-微小RNA（miRNAs）和EV-长链非编码RNA在胃肠道癌症中显示出显著的诊断和预后价值。本综述广泛介绍了EVs在胃肠道癌症中的生物发生、分子特性和功能作用，重点关注其临床应用。
