外泌体在妇科恶性肿瘤中的作用及临床应用进展  

The Role and Clinical Application Progress of Exosomes in Gynecological Malignancies

作　　者：张凤梅 李红芳 ZHANG Fengmei;LI Hongfang(First Clinical Medical School,Gansu University of Chinese Medicine,Lanzhou 730000,China;Department of Obstetrics and Gynecology,The First People’s Hospital of Lanzhou City,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃兰州730000 [2]兰州市第一人民医院妇产科,甘肃兰州730000

出　　处：《中山大学学报(医学科学版)》2025年第2期266-274,共9页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：兰州市卫生健康行业科研项目(A2023008)。

摘　　要：外泌体是具有脂质双层膜结构的小囊泡,因其非侵入性、高可及性和稳定性应用于精准医学中,在肿瘤的转移、侵袭和血管生成等过程中发挥重要作用。妇科恶性肿瘤主要包括宫颈癌、卵巢癌和子宫内膜癌,其早期诊断和治疗一直是研究的热点和难点。外泌体作为新型的生物学标志物,具有高度特异性,能够有效阻断妇科恶性肿瘤的发生和发展。本文详细探讨了外泌体在宫颈癌、卵巢癌和子宫内膜癌中的诊断和治疗应用。在宫颈癌中,外泌体参与HPV感染、血管生成和免疫逃逸等过程,其携带的特定miRNA(如miR-30d-5p、let-7d-3p)可作为诊断标志物。此外,外泌体还可作为靶向药物递送载体和疫苗研发平台。在卵巢癌中,外泌体携带的miRNA(如miR-21、miR-200家族)对早期诊断具有参考价值,且外泌体在化疗耐药和肿瘤进展中扮演重要角色。对于子宫内膜癌,外泌体中的miRNA(如miR-15a-5p、miR-106b-5p)可作为早期检测的生物标志物。此外,本文还指出了外泌体在临床应用中面临的挑战,如分离提取的复杂性和细胞来源的识别等,并强调了进一步的基础研究和临床试验的必要性。本文为妇科恶性肿瘤的早期诊断和精准治疗提供了新的思路和方法,具有重要的理论和临床意义。Exosomes are small vesicles with a lipid bilayer membrane structure that have applied in precision medicine due to their non-invasive nature,high accessibility,and stability.Exosomes play a crucial role in processes such as tumor metastasis,invasion,and angiogenesis.Gynecological malignancies primarily include cervical cancer,ovarian cancer,and endometrial cancer,and their early diagnosis and treatment have long been a focus of research.As novel biological markers,exosomes exhibit high specificity and can effectively block the occurrence and progression of gynecological malignancies.This article explores the diagnostic and therapeutic applications of exosomes in cervical cancer,ovarian cancer,and endometrial cancer in detail.In cervical cancer,exosomes are involved in processes such as HPV infection,angiogenesis,and immune evasion,with specific miRNAs(such as miR-30d-5p and let-7d-3p)serving as diagnostic markers.Furthermore,exosomes can act as targeted drug delivery vehicles and vaccine development platforms.In ovarian cancer,the miRNAs carried by exosomes(such as miR-21 and the miR-200 family)have reference value for early diagnosis,and exosomes play an important role in chemotherapy resistance and tumor progression.For endometrial cancer,miRNAs in exosomes(such as miR-15a-5p and miR-106b-5p)can serve as biomarkers for early detection.Additionally,this article highlights the challenges faced by exosomes in clinical applications,such as the complexity of isolation and extraction and the identification of cell sources,and emphasizes the necessity for further basic research and clinical trials.This study provides new ideas and methods for the early diagnosis and precision treatment of gynecological malignancies,holding significant theoretical and clinical importance.

关 键 词：外泌体 妇科恶性肿瘤 宫颈癌 卵巢癌 子宫内膜癌 临床应用 

分 类 号：R737.3[医药卫生—肿瘤]