文献解析 | 肿瘤标志物新探索：外泌体在结直肠癌诊断中的潜力

结直肠癌（CRC），作为一种胃肠道的致命恶性肿瘤，其死亡率已攀升至9.2%，其隐匿的早期症状与晚期高转移性共同导致了低诊断率与高致死率，凸显了精准检测对防控CRC的至关重要性。当前，CRC的检测手段多样，包括结肠镜、癌胚抗原（CEA）检测、乙状结肠镜、粪便DNA分析及septin9基因甲基化检测等，其中结肠镜与CEA检测虽为常用，但前者因侵入性与不适感、后者则受限于灵敏性与特异性，均非尽善尽美。因此，探求便捷高效的新检测手段，对于CRC的早期诊断与预后评估至关重要。

最新刊登于《Cancer Letters》的研究成果，聚焦于外泌体作为CRC生物标志物的潜力及其在多环节（如转移、耐药、复发）中的显著作用。外泌体，作为源自正常或癌细胞的小巧纳米囊泡，其独特优势在于：一、在敏感性与特异性上可能超越传统方法；二、富含多种生物活性分子，有效抵御血清干扰；三、稳定性卓越，能在细胞外环境中长期保持完整；四、广泛分布于多种体液，便于非侵入性检测。当然，该研究亦不避讳外泌体应用的局限，整体而言，外泌体被视为CRC生物标志物领域的一颗璀璨新星。

Exosomes aspotential sources of biomarkers in colorectal cancer

Colorectal cancer (CRC), a common malignancy, is among the leading causes of cancer-related deaths worldwide. Developing novel biomarkers is an important public health strategy to effectively reduce the mortality of this disease. Recent studies have found that exosomes may be important sources of biomarkers in CRC. Exosomes are nanometer-sized membrane vesicles (30-200 nm) secreted by normal or cancer cells, which participate in intercellular communication by transporting RNAs and proteins. Accumulating evidence has shown that some differentially expressed RNAs and proteins in exosomes play key roles in the initiation and development of CRC and are potential candidates for malignancy detection. Accordingly, exploring the correlation between these exosomes and CRC may be beneficial for the development of novel biomarkers in this disease. Here, we summarize the important roles of exosomes as biomarkers in CRC diagnosis, as well as the application in the metastasis, chemoresistance, and recrudescence of CRC. In particular, we discuss the prospects and limitations of exosomes as tumor markers.

鉴于CRC的高致死率，寻找新型生物标志物成为公共卫生领域的迫切需求。外泌体，凭借其作为细胞间信息传递使者的角色，特别是其内含的差异表达RNA与蛋白质在CRC病理进程中的关键作用，正逐步揭开其作为CRC检测新靶点的神秘面纱。深入探究外泌体与CRC之间的紧密联系，有望为CRC的早期诊断、治疗监测及复发预测提供强有力的工具，尽管其全面应用尚需克服一定挑战。