外泌体在白血病发生发展及诊断中的应用价值研究进展

Research progress on the application value of extracellular vesicles in the occurrence,development,and diagnosis of leukemia

白血病(leukemia)患者造血组织中某一血细胞系统过度增生,并伴随分化阻滞、凋亡受阻,以及在骨髓中大量堆积。随着病情发展增生细胞可侵袭至其他器官或组织,导致出现一系列临床表现的恶性克隆性疾病。青壮年及其以下人群白血病发病率较高,儿童为白血病的高发人群。随着治疗新技术的发展,白血病的完全缓解率得到了一定的提高,但早期漏诊率和复发率仍然较高,因此,白血病的早期诊断及复发率检测非常重要。外泌体可以调节及控制细胞之间的物质交换和信息传递,同时可影响白血病发生发展过程及复发等多个环节,可作为白血病的重要监测指标,以降低白血病早期误诊、漏诊率,同时可提高白血病耐药监测能力和预后判断的准确性。本文就外泌体在白血病发生发展过程中发挥的多重作用和在白血病诊断及治疗中的应用方面进行综述,以期为外泌体辅助白血病早期诊断、治疗以及复发监测等方面提供理论基础。

Leukemia,also known as blood cancer,is the hyperplasia of a blood cell system in hematopoietic tissue,infiltrating into various tissues and organs,resulting in a series of clinical manifestations of malignant blood diseases.In malignant tumor,the incidence of leukemia in young and middle-aged people is high,and children are often affected.Therefore,the metastasis,treatment and recurrence of leukemia are widely concerned.With the development of treatment,the rate of complete response has improved,but there are still high rates of early missed diagnosis and recurrence.Consequently,the early diagnosis and recurrence rate detection of leukemia are particularly important.Recent studies have found that exosomes can regulate and control the material exchange and information transmission between cells,and participate in the development and drug resistance of leukemia.By monitoring exosomes in peripheral blood or other body fluids,the diagnostic efficiency,drug resistance monitoring and prognosis of leukemia can be improved.In this paper,multiple roles of exosomes in the occurrence and development of leukemia and their application in the diagnosis and treatment of leukemia as well as related clinical significance are reviewed,providing a theoretical basis for the aid of exosomes in early diagnosis,novel treatment and drug resistance monitoring of leukemia.