肿瘤微环境是肿瘤滋生的地基，对结直肠癌（CRC）的发展和进展起着关键作用。环境中的各种细胞信号分子促进肿瘤血管新生、免疫耐受并促进免疫逃避。作为肿瘤与宿主细胞之间的信使，外泌体被认为是参与肿瘤加速环境的关键介质。然而，CRC微环境中的外泌体介导通信网络仍然不是很清楚。在本综述中，我们根据最近的文献总结了TME和CRC之间的关系。然后，我们揭示了外泌体在CRC的菌群、缺氧、炎症和免疫微环境中的调节作用，以及它们的独特影响和信号分子。最后，我们总结了外泌体在CRC微环境中的治疗效果，并讨论了它们的现状和前景，旨在为CRC治疗提供新的分子靶点和理论基础。© 2023 UICC.

Tumor microenvironment, the soil where tumor thrives, plays a critical role in the development and progression of colorectal cancer (CRC). Various cell signaling molecules in the environment promote tumor angiogenesis, immune tolerance and facilitate immune escape. Exosomes, as messengers between tumor and host cells, are considered key mediators involved in the tumor-accelerating environment. However, the exosome-mediated communication networks in the CRC microenvironment are still largely unclear. In this review, we summarized the relationship between TME and CRC based on recent literature. Then, we revealed the unique impacts and signal molecules of exosomes on account of their regulatory role in the flora, hypoxia, inflammatory and immunological microenvironment of CRC. Finally, we summarized the therapeutically effective of exosomes in CRC microenvironment and discussed their current status and prospects, aiming to provide new molecular targets and a theoretical basis for the CRC treatment.© 2023 UICC.