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Unveiling Parkinson's disease through biomarker research: current insights and future prospects. 通过生物标记物研究揭示帕金森病:当前见解与未来展望。
IF 6.6 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-11-01 Epub Date: 2024-03-26 DOI: 10.1080/10408363.2024.2331471
Nazlı Durmaz Celik, Serkan Ozben, Tomris Ozben

Parkinson's disease (PD) is a neurodegenerative condition marked by the gradual depletion of dopaminergic neurons in the substantia nigra. Despite substantial strides in comprehending potential causative mechanisms, the validation of biomarkers with unequivocal evidence for routine clinical application remains elusive. Consequently, the diagnosis heavily relies on patients' clinical assessments and medical backgrounds. The imperative need for diagnostic and prognostic biomarkers arises due to the prevailing limitations of treatments, which predominantly address symptoms without modifying the disease course. This comprehensive review aims to elucidate the existing landscape of diagnostic and prognostic biomarkers for PD, drawing insights from contemporary literature.

帕金森病(PD)是一种神经退行性疾病,其特征是黑质中的多巴胺能神经元逐渐耗竭。尽管在理解潜在的致病机制方面取得了长足进步,但具有明确证据的生物标志物在常规临床应用中的验证仍然遥遥无期。因此,诊断在很大程度上依赖于患者的临床评估和医学背景。由于目前治疗方法的局限性,主要针对症状而不改变病程,因此迫切需要诊断和预后生物标志物。本综述旨在从当代文献中汲取灵感,阐明现有的帕金森病诊断和预后生物标志物。
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引用次数: 0
Research progress of KL-6 in respiratory system diseases. KL-6 在呼吸系统疾病中的研究进展。
IF 6.6 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-11-01 Epub Date: 2024-05-21 DOI: 10.1080/10408363.2024.2350374
Yi Gao, Tianming Du, Lianbo Yang, Lina Wu

This article comprehensively elucidates the discovery of Krebs von den Lungen-6 (KL-6), its structural features, functional mechanisms, and the current research status in various respiratory system diseases. Discovered in 1985, KL-6 was initially considered a tumor marker, but its elevated levels in interstitial lung disease (ILD) led to its recognition as a relevant serum marker for ILD. KL-6 is primarily produced by type 2 alveolar epithelial cell regeneration. Over the past 30 years since the discovery of KL-6, the number of related research papers has steadily increased annually. Following the coronavirus disease 2019 (COVID-19) pandemic, there has been a sudden surge in relevant literature. Despite KL-6's potential as a biomarker, its value in the diagnosis, treatment, and prognosis varies across different respiratory diseases, including ILD, idiopathic pulmonary fibrosis (IPF), COVID-19, and lung cancer. Therefore, as an important serum biomarker in respiratory system diseases, the value of KL-6 still requires further investigation.

本文全面阐述了克雷布斯-冯登肺素-6(Krebs von den Lungen-6,KL-6)的发现、结构特征、功能机制以及在各种呼吸系统疾病中的研究现状。KL-6 发现于 1985 年,最初被认为是一种肿瘤标志物,但其在间质性肺病(ILD)中的水平升高使其被认为是 ILD 的相关血清标志物。KL-6 主要由 2 型肺泡上皮细胞再生产生。自KL-6被发现以来的30年间,相关研究论文的数量每年都在稳步增长。2019 年冠状病毒病(COVID-19)大流行后,相关文献突然激增。尽管KL-6具有作为生物标志物的潜力,但其在不同呼吸系统疾病(包括ILD、特发性肺纤维化(IPF)、COVID-19和肺癌)的诊断、治疗和预后中的价值各不相同。因此,作为呼吸系统疾病的重要血清生物标志物,KL-6 的价值仍有待进一步研究。
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引用次数: 0
The role of immunophenotyping in common variable immunodeficiency: a narrative review. 免疫分型在常见可变免疫缺陷症中的作用:综述。
IF 6.6 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-04 DOI: 10.1080/10408363.2024.2404842
Jana Neirinck, Malicorne Buysse, Ciel De Vriendt, Mattias Hofmans, Carolien Bonroy

Common variable immunodeficiency (CVID) is a heterogeneous primary immunodeficiency (PID) characterized by an impaired immunoglobulin production, in association with an increased susceptibility to infections and a diversity of clinical manifestations. This narrative review summarizes immunophenotypic abnormalities in CVID patients and their relevance for diagnosis and disease classification. A comprehensive search across four databases - PubMED, Web of Science, EMBASE and Google Scholar - yielded 170 relevant studies published between 1988 and April 31, 2023. Over the past decades, the role of immunophenotyping in CVID diagnosis has become evident by identifying "hallmark" immunophenotypic aberrancies in patient subsets, with some now integrated in the consensus diagnostic criteria. Furthermore, the role of immunophenotyping in subclassifying CVID in relation to clinical presentation and prognosis has been extensively studied. Certain immunophenotypic patterns consistently correlate with clinical manifestations and/or subsets of CVID, particularly those associated with noninfectious complications (i.e. low switched memory B cells, shifts in follicular helper T cell subsets, low naïve CD4+ T cells, low regulatory T cells, and expansion of CD21low B cells, often associated with autoimmunity and/or splenomegaly). Also, efforts to associate subset levels of innate immune cells, such as Natural Killer (NK) cells, invariant (i)NKT cells, innate lymphoid cells (ILCs), and dendritic cells (DCs) to CVID complications are evident albeit in a lesser degree. However, inconsistencies regarding the role of flow cytometry in classification and prognosis persist, reflecting the disease complexity, but probably also cohort variations and methodological differences between published studies. This underscores the need for collaborative efforts to integrate emerging concepts, such as standardized flow cytometry and computational tools, for a more precise CVID classification approach. Additionally, recent studies suggest a potential value of (epi)genetic-based molecular assays to this effort.

常见变异性免疫缺陷病(CVID)是一种异质性原发性免疫缺陷病(PID),其特点是免疫球蛋白生成障碍,同时伴有感染易感性增加和临床表现多样性。这篇叙述性综述总结了 CVID 患者的免疫表型异常及其与诊断和疾病分类的相关性。通过对 PubMED、Web of Science、EMBASE 和 Google Scholar 四个数据库的全面检索,我们找到了 1988 年至 2023 年 4 月 31 日期间发表的 170 篇相关研究。在过去的几十年中,免疫分型在 CVID 诊断中的作用已变得显而易见,它能确定患者亚群的 "标志性 "免疫分型异常,其中一些已被纳入共识诊断标准。此外,免疫分型在与临床表现和预后有关的 CVID 亚分类中的作用已得到广泛研究。某些免疫表型模式始终与 CVID 的临床表现和/或亚型相关,尤其是那些与非感染性并发症相关的免疫表型模式(即低转换记忆 B 细胞、滤泡辅助 T 细胞亚型的转变、低幼稚 CD4+ T 细胞、低调节性 T 细胞和 CD21 低 B 细胞的扩增,通常与自身免疫和/或脾肿大相关)。此外,自然杀伤(NK)细胞、不变(i)NKT 细胞、先天性淋巴细胞(ILCs)和树突状细胞(DCs)等先天性免疫细胞亚群水平与 CVID 并发症的关系也很明显,尽管程度较轻。然而,流式细胞术在分类和预后中的作用仍不一致,这反映了疾病的复杂性,也可能是已发表研究的队列差异和方法差异所致。这凸显了将标准化流式细胞术和计算工具等新兴概念整合到更精确的 CVID 分类方法中的合作必要性。此外,最近的研究表明,基于(外)遗传学的分子检测对这项工作具有潜在价值。
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引用次数: 0
Correction. 更正。
IF 6.6 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-01 Epub Date: 2024-03-23 DOI: 10.1080/10408363.2024.2327873
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引用次数: 0
The multidimensional value of natriuretic peptides in heart failure, integrating laboratory and clinical aspects. 心力衰竭中钠尿肽的多维价值,实验室与临床相结合。
IF 6.6 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-01 Epub Date: 2024-03-25 DOI: 10.1080/10408363.2024.2319578
Damien Gruson, Angelika Hammerer-Lercher, Paul Collinson, Christopher Duff, Hannsjörg Baum, Kari Pulkki, Janne Suvisaari, Sanja Stankovic, Paivi Laitinen, Antoni Bayes-Genis

Natriuretic peptides (NP) play an essential role in heart failure (HF) regulation, and their measurement has improved diagnostic and prognostic accuracy. Clinical symptoms and objective measurements, such as NP levels, should be included in the HF definition to render it more reliable and consistent among observers, hospitals, and healthcare systems. BNP and NT-proBNP are reasonable surrogates for cardiac disease, and their measurement is critical to early diagnosis and risk stratification of HF patients. NPs should be measured in all patients presenting with dyspnea or other symptoms suggestive of HF to facilitate early diagnosis and risk stratification. Both BNP and NT-proBNP are currently used for guided HF management and display comparable diagnostic and prognostic accuracy. Standardized cutoffs for each NP assay are essential for data comparison. The value of NP testing is recognized at various levels, including patient empowerment and education, analytical and operational issues, clinical HF management, and cost-effectiveness.

Natriuretic peptides(NP)在心力衰竭(HF)调节过程中发挥着重要作用,对其进行测量可提高诊断和预后的准确性。临床症状和客观测量指标(如 NP 水平)应纳入心力衰竭的定义中,以使其在观察者、医院和医疗系统之间更加可靠和一致。BNP 和 NT-proBNP 是心脏疾病的合理替代指标,对它们的测量对于早期诊断和对心房颤动患者进行风险分层至关重要。所有出现呼吸困难或其他提示心房颤动症状的患者都应测量 NPs,以促进早期诊断和风险分层。目前,BNP 和 NT-proBNP 均用于指导心房颤动管理,其诊断和预后准确性相当。每种 NP 检测方法的标准化临界值对于数据比较至关重要。NP 检测的价值在各个层面都得到了认可,包括患者授权和教育、分析和操作问题、临床心房颤动管理以及成本效益。
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引用次数: 0
The role of bile acid metabolism in bone and muscle: from analytics to mechanisms. 胆汁酸代谢在骨骼和肌肉中的作用:从分析到机制。
IF 6.6 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-01 Epub Date: 2024-03-15 DOI: 10.1080/10408363.2024.2323132
Markus Herrmann, Giovanny Rodriguez-Blanco, Marco Balasso, Katarzyna Sobolewska, Maria Donatella Semeraro, Nerea Alonso, Wolfgang Herrmann

Osteoporosis and sarcopenia are both common age-related disorders that are associated with increased morbidity and mortality. Bone and muscle are metabolically very active tissues that require large amounts of energy. Bile acids (BAs), a group of liver-derived steroid compounds, are primarily known as emulsifiers that facilitate the resorption of dietary fat and lipids. In addition, they have pleiotropic metabolic functions in lipoprotein and glucose metabolism, inflammation, and intestinal bacterial growth. Through these effects, they are related to metabolic diseases, such as diabetes, hypertriglyceridemia, atherosclerosis, and nonalcoholic steatohepatitis. BAs mediate their metabolic effects through receptor dependent and receptor-independent mechanisms. Emerging evidence suggests that BAs are also involved in bone and muscle metabolism. Under normal circumstances, BAs support bone health by shifting the delicate equilibrium of bone turnover toward bone formation. In contrast, low or excessive amounts of BAs promote bone resorption. In cholestatic liver disease, BAs accumulate in the liver, reach toxic concentrations in the circulation, and thus may contribute to bone loss and muscle wasting. In addition, the measurement of BAs is in rapid evolution with modern mass spectrometry techniques that allow for the detection of a continuously growing number of BAs. This review provides a comprehensive overview of the biochemistry, physiology and measurement of bile acids. Furthermore, it summarizes the existing literature regarding their role in bone and muscle.

骨质疏松症和肌肉疏松症都是常见的老年性疾病,与发病率和死亡率的增加有关。骨骼和肌肉是新陈代谢非常活跃的组织,需要大量能量。胆汁酸(BA)是一类来源于肝脏的类固醇化合物,主要作为乳化剂促进饮食中脂肪和脂质的吸收。此外,胆汁酸还在脂蛋白和葡萄糖代谢、炎症和肠道细菌生长方面具有多种代谢功能。通过这些作用,它们与糖尿病、高甘油三酯血症、动脉粥样硬化和非酒精性脂肪性肝炎等代谢性疾病有关。BAs 通过受体依赖性和受体非依赖性机制介导其代谢效应。新的证据表明,BAs 还参与骨骼和肌肉的新陈代谢。在正常情况下,BA 可使骨转换的微妙平衡转向骨形成,从而促进骨骼健康。相反,低量或过量的 BAs 会促进骨吸收。在胆汁淤积性肝病中,BA 在肝脏中蓄积,在血液循环中达到毒性浓度,从而可能导致骨质流失和肌肉萎缩。此外,随着现代质谱技术的发展,BAs 的测量方法也在迅速演变,可检测的 BAs 种类不断增多。本综述全面概述了胆汁酸的生物化学、生理学和测量方法。此外,它还总结了有关胆汁酸在骨骼和肌肉中作用的现有文献。
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引用次数: 0
DNA/RNA-based electrochemical nanobiosensors for early detection of cancers. 用于癌症早期检测的基于 DNA/RNA 的电化学纳米生物传感器。
IF 6.6 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-01 Epub Date: 2024-03-07 DOI: 10.1080/10408363.2024.2321202
Babak Mikaeeli Kangarshahi, Seyed Morteza Naghib, Navid Rabiee

Nucleic acids, like DNA and RNA, serve as versatile recognition elements in electrochemical biosensors, demonstrating notable efficacy in detecting various cancer biomarkers with high sensitivity and selectivity. These biosensors offer advantages such as cost-effectiveness, rapid response, ease of operation, and minimal sample preparation. This review provides a comprehensive overview of recent developments in nucleic acid-based electrochemical biosensors for cancer diagnosis, comparing them with antibody-based counterparts. Specific examples targeting key cancer biomarkers, including prostate-specific antigen, microRNA-21, and carcinoembryonic antigen, are highlighted. The discussion delves into challenges and limitations, encompassing stability, reproducibility, interference, and standardization issues. The review suggests future research directions, exploring new nucleic acid recognition elements, innovative transducer materials and designs, novel signal amplification strategies, and integration with microfluidic devices or portable instruments. Evaluating these biosensors in clinical settings using actual samples from cancer patients or healthy donors is emphasized. These sensors are sensitive and specific at detecting non-communicable and communicable disease biomarkers. DNA and RNA's self-assembly, programmability, catalytic activity, and dynamic behavior enable adaptable sensing platforms. They can increase biosensor biocompatibility, stability, signal transduction, and amplification with nanomaterials. In conclusion, nucleic acids-based electrochemical biosensors hold significant potential to enhance cancer detection and treatment through early and accurate diagnosis.

核酸(如 DNA 和 RNA)是电化学生物传感器中的多功能识别元件,在高灵敏度和高选择性检测各种癌症生物标志物方面具有显著功效。这些生物传感器具有成本效益高、反应速度快、操作简便、样品制备量少等优点。本综述全面概述了用于癌症诊断的基于核酸的电化学生物传感器的最新发展,并将其与基于抗体的生物传感器进行了比较。重点介绍了针对关键癌症生物标志物的具体实例,包括前列腺特异性抗原、microRNA-21 和癌胚抗原。讨论深入探讨了挑战和局限性,包括稳定性、再现性、干扰和标准化问题。综述提出了未来的研究方向,探索新的核酸识别元件、创新的传感器材料和设计、新的信号放大策略,以及与微流控设备或便携式仪器的整合。强调在临床环境中使用癌症患者或健康捐赠者的实际样本对这些生物传感器进行评估。这些传感器在检测非传染性和传染性疾病生物标志物方面具有灵敏性和特异性。DNA 和 RNA 的自组装、可编程性、催化活性和动态行为使其成为适应性强的传感平台。它们可以提高生物传感器的生物相容性、稳定性、信号传导性,并利用纳米材料进行放大。总之,基于核酸的电化学生物传感器在通过早期准确诊断提高癌症检测和治疗方面具有巨大潜力。
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引用次数: 0
KIF2C/MCAK a prognostic biomarker and its oncogenic potential in malignant progression, and prognosis of cancer patients: a systematic review and meta-analysis as biomarker. 作为预后生物标志物的 KIF2C/MCAK 及其在癌症患者恶性进展和预后中的致癌潜力:作为生物标志物的系统综述和荟萃分析。
IF 6.6 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-01 Epub Date: 2024-02-12 DOI: 10.1080/10408363.2024.2309933
Nina-Naomi Kreis, Ha Hyung Moon, Linda Wordeman, Frank Louwen, Christine Solbach, Juping Yuan, Andreas Ritter

KIF2C/MCAK (KIF2C) is the most well-characterized member of the kinesin-13 family, which is critical in the regulation of microtubule (MT) dynamics during mitosis, as well as interphase. This systematic review briefly describes the important structural elements of KIF2C, its regulation by multiple molecular mechanisms, and its broad cellular functions. Furthermore, it systematically summarizes its oncogenic potential in malignant progression and performs a meta-analysis of its prognostic value in cancer patients. KIF2C was shown to be involved in multiple crucial cellular processes including cell migration and invasion, DNA repair, senescence induction and immune modulation, which are all known to be critical during the development of malignant tumors. Indeed, an increasing number of publications indicate that KIF2C is aberrantly expressed in multiple cancer entities. Consequently, we have highlighted its involvement in at least five hallmarks of cancer, namely: genome instability, resisting cell death, activating invasion and metastasis, avoiding immune destruction and cellular senescence. This was followed by a systematic search of KIF2C/MCAK's expression in various malignant tumor entities and its correlation with clinicopathologic features. Available data were pooled into multiple weighted meta-analyses for the correlation between KIF2Chigh protein or gene expression and the overall survival in breast cancer, non-small cell lung cancer and hepatocellular carcinoma patients. Furthermore, high expression of KIF2C was correlated to disease-free survival of hepatocellular carcinoma. All meta-analyses showed poor prognosis for cancer patients with KIF2Chigh expression, associated with a decreased overall survival and reduced disease-free survival, indicating KIF2C's oncogenic potential in malignant progression and as a prognostic marker. This work delineated the promising research perspective of KIF2C with modern in vivo and in vitro technologies to further decipher the function of KIF2C in malignant tumor development and progression. This might help to establish KIF2C as a biomarker for the diagnosis or evaluation of at least three cancer entities.

KIF2C/MCAK(KIF2C)是驱动蛋白-13 家族中特征最明显的成员,在有丝分裂和间期的微管(MT)动力学调控中起着关键作用。这篇系统综述简要介绍了 KIF2C 的重要结构元素、多种分子机制对其的调控及其广泛的细胞功能。此外,它还系统地总结了KIF2C在恶性肿瘤进展中的致癌潜力,并对其在癌症患者中的预后价值进行了荟萃分析。研究表明,KIF2C参与了多个关键的细胞过程,包括细胞迁移和侵袭、DNA修复、衰老诱导和免疫调节,这些过程在恶性肿瘤的发展过程中都至关重要。事实上,越来越多的文献表明,KIF2C在多种癌症实体中异常表达。因此,我们强调它至少参与了癌症的五个特征,即:基因组不稳定性、抵抗细胞死亡、激活侵袭和转移、避免免疫破坏和细胞衰老。随后,对 KIF2C/MCAK 在各种恶性肿瘤实体中的表达及其与临床病理特征的相关性进行了系统检索。将现有数据汇集成多个加权荟萃分析,研究 KIF2 高蛋白或基因表达与乳腺癌、非小细胞肺癌和肝细胞癌患者总生存率之间的相关性。此外,KIF2C的高表达还与肝细胞癌的无病生存率相关。所有荟萃分析均显示,KIF2高表达的癌症患者预后较差,与总生存率降低和无病生存率降低有关,这表明KIF2C在恶性进展中具有致癌潜力,也是一种预后标志物。这项工作利用现代体内和体外技术勾勒出了KIF2C的研究前景,以进一步解密KIF2C在恶性肿瘤发生和发展中的功能。这可能有助于将KIF2C确立为诊断或评估至少三种癌症实体的生物标志物。
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引用次数: 0
Implication of calcium supplementations in health and diseases with special focus on colorectal cancer. 补钙对健康和疾病的影响,特别关注结肠直肠癌。
IF 6.6 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-01 Epub Date: 2024-03-08 DOI: 10.1080/10408363.2024.2322565
Shahanavaj Khan, S Needa Mosvi, Saeed Vohra, Nitesh Kumar Poddar

Calcium is a fundamental and integrative element and helps to ensure optimal health by regulating various physiological and pathological processes. While there is substantiated evidence confirming the beneficial effects of calcium in the treatment, management, and prevention of various health conditions, including cancer, conflicting studies are imperative to acknowledge the potential negative role of calcium supplementation. The studies on calcium supplementation showed that a specific dose can help in the maintenance of good human health, and in the control of different types of diseases, including cancer. Calcium alone and when combined with vitamin D, emerges as a promising therapeutic option for efficiently managing cancer growth, when used with chemotherapy. Combination therapy is considered a more effective approach for treating advanced types of colorectal cancer. Nevertheless, several challenges drastically influence the treatment of cancer, such as individual discrepancy, drug resistance, and stage of cancer, among others. Henceforth, novel preventive, reliable therapeutic modalities are essential to control and reduce the incidence and mortality of colorectal cancer (CRC). The calcium-sensing receptor (CaSR) plays a pivotal role in calcium homeostasis, metabolism, and regulation of oncogenesis. Numerous studies have underscored the potential of CaSR, a G protein-coupled receptor, as a potential biomarker and target for colorectal cancer prevention and treatment. The multifaceted involvement of CaSR in anti-inflammatory and anti-carcinogenic processes paves the way for its utilization in the diagnosis and management of colorectal cancer. The current review highlights the important role of supplemental calcium in overall health and disease, along with the exploration of intricate mechanisms of CaSR pathways in the management and prevention of colorectal cancer.

钙是一种基本的综合元素,通过调节各种生理和病理过程,有助于确保最佳健康状态。虽然有确凿证据证实钙对治疗、控制和预防包括癌症在内的各种健康状况有益,但相互矛盾的研究也必须承认补钙的潜在负面作用。有关补钙的研究表明,一定剂量的钙有助于维持人体健康,控制包括癌症在内的各种疾病。单独补钙或与维生素 D 结合使用,与化疗一起使用,可有效控制癌症的生长。综合疗法被认为是治疗晚期结直肠癌的更有效方法。然而,个体差异、耐药性和癌症分期等一些挑战极大地影响着癌症的治疗。因此,新型的预防性可靠治疗方法对于控制和降低结直肠癌(CRC)的发病率和死亡率至关重要。钙感应受体(CaSR)在钙平衡、新陈代谢和肿瘤发生调控中发挥着关键作用。大量研究强调了钙传感受体(一种 G 蛋白偶联受体)作为潜在生物标志物和结直肠癌预防与治疗靶点的潜力。CaSR 在抗炎和抗癌过程中的多方面参与为其在结直肠癌诊断和治疗中的应用铺平了道路。本综述强调了补充钙质在整体健康和疾病中的重要作用,同时探讨了 CaSR 通路在管理和预防结直肠癌中的复杂机制。
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引用次数: 0
Extracellular vesicles in cancer: challenges and opportunities for clinical laboratories. 癌症中的细胞外囊泡:临床实验室的挑战与机遇。
IF 6.6 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-01 Epub Date: 2024-02-15 DOI: 10.1080/10408363.2024.2309935
Álvaro González, Silvia López-Borrego, Amaia Sandúa, Mar Vales-Gomez, Estibaliz Alegre

Extracellular vesicles (EVs) are nano-sized particles secreted by most cells. They transport different types of biomolecules (nucleic acids, proteins, and lipids) characteristic of their tissue or cellular origin that can mediate long-distance intercellular communication. In the case of cancer, EVs participate in tumor progression by modifying the tumor microenvironment, favoring immune tolerance and metastasis development. Consequently, EVs have great potential in liquid biopsy for cancer diagnosis, prognosis and follow-up. In addition, EVs could have a role in cancer treatment as a targeted drug delivery system. The intense research in the EV field has resulted in hundreds of patents and the creation of biomedical companies. However, methodological issues and heterogeneity in EV composition have hampered the advancement of EV validation trials and the development of EV-based diagnostic and therapeutic products. Consequently, only a few EV biomarkers have moved from research to clinical laboratories, such as the ExoDx Prostate IntelliScore (EPI) test, a CLIA/FDA-approved EV prostate cancer diagnostic test. In addition, the number of large-scale multicenter studies that would clearly define biomarker performance is limited. In this review, we will critically describe the different types of EVs, the methods for their enrichment and characterization, and their biological role in cancer. Then, we will specially focus on the parameters to be considered for the translation of EV biology to the clinic laboratory, the advances already made in the field of EVs related to cancer diagnosis and treatment, and the issues still pending to be solved before EVs could be used as a routine tool in oncology.

细胞外囊泡(EVs)是大多数细胞分泌的纳米级颗粒。它们运输不同类型的生物大分子(核酸、蛋白质和脂质),这些大分子具有其组织或细胞来源的特征,可以介导长距离的细胞间通信。就癌症而言,EVs 可通过改变肿瘤微环境、促进免疫耐受和转移发展来参与肿瘤进展。因此,EVs 在用于癌症诊断、预后和随访的液体活检中具有巨大潜力。此外,EVs 还可作为靶向给药系统在癌症治疗中发挥作用。EV 领域的深入研究已产生了数百项专利,并创建了多家生物医学公司。然而,方法问题和 EV 成分的异质性阻碍了 EV 验证试验的进展以及基于 EV 的诊断和治疗产品的开发。因此,只有少数 EV 生物标志物从研究阶段进入了临床实验室,如 ExoDx Prostate IntelliScore(EPI)检测,这是一种获得 CLIA/FDA 批准的 EV 前列腺癌诊断检测。此外,能明确界定生物标记物性能的大规模多中心研究数量有限。在这篇综述中,我们将对不同类型的 EVs、其富集和表征方法及其在癌症中的生物学作用进行批判性描述。然后,我们将特别关注将 EV 生物学转化为临床实验室需要考虑的参数、与癌症诊断和治疗相关的 EV 领域已取得的进展,以及在将 EV 用作肿瘤学常规工具之前仍有待解决的问题。
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