外泌体检测在骨肿瘤诊疗中的意义

Significance of exosome detection in the diagnosis and treatment of malignant tumors

体液活检是近些年恶性肿瘤研究的热点。液态活检包括游离DNA(circulating free DNA,cf DNA)检测、循环肿瘤细胞(cir-culating tumor cells,CTCs)检测、细胞外泌体检测。对于间叶组织来源的骨肉瘤和尤文肉瘤而言,由于肿瘤异质性明显同时又缺乏经典的肿瘤标志物,以细胞标志物为手段的循环肿瘤细胞检测在骨肉瘤和尤文肉瘤等间叶组织来源恶性肿瘤的预后监测中的作用受到明显制约。体液中存在的肿瘤细胞外泌体因携带其"母体"肿瘤细胞的部分功能性蛋白及基因,并作为肿瘤液态活检的一种新途径,受到大家的广泛关注,其也可能在骨肉瘤和尤文肉瘤的发病、诊断和治疗中发挥着重要作用。本文旨在对外泌体的特性、在恶性肿瘤进展中发挥的重要作用及应用前景进行综述,以期为实现其在临床中的推广应用提供参考。

Exosomes have been intensively studied in recent decades. A liquid biopsy can detect exosomes as well as circulating free DNA（cf DNA） and circulating tumor cells（CTCs）. For osteosarcoma and Ewing sarcoma, which are derived from mesenchymal tissue, tumor heterogeneity can significantly affect the role of circulating tumor cells for monitoring prognosis based on the selected cell markers. This limitation has caused attention on exosomes derived from the maternal tumor cells because of the presence of maternal proteins and genes. The exosomes carrying their maternal partial functional proteins and genes may have an effect on tumorigenesis, and their detection may be beneficial for the diagnosis and treatment of osteosarcoma and Ewing sarcoma. This article reviews advances in knowledge on the exosome properties, the effect of exosomes on malignant tumorigenesis, and their clinical application. The data will provide a reference for clinical practitioners.