癌干细胞（CSCs）是肿瘤中特定的一类细胞，负责启动、推进并抵抗传统癌症治疗。M2巨噬细胞，也称为替代激活的巨噬细胞，通过促进血管生成、抑制免疫系统、支持肿瘤生长和促进转移，有助于肿瘤的发展和进展。细胞释放的微小囊泡，即外泌体，在细胞间通信中发挥着关键作用，并且已被证明与癌症的发展和进展有关，通过影响免疫应答，它们可能作为诊断和预后的标志物。目前，研究源自M2巨噬细胞的外泌体对CSCs维持的影响是一个关键的研究领域，旨在开发新的治疗策略，以针对这一过程并改善癌症患者的预后。了解源自M2巨噬细胞的外泌体的生物学功能及其在癌症中的参与，可能导致制定新的诊断工具和治疗方法。通过靶向M2巨噬细胞及其分泌的外泌体，有望在癌症治疗中出现有希望的前景，因为它们对癌症的发展和进展有着重大的贡献。需要进一步研究来全面了解CSCs、M2巨噬细胞和外泌体在癌症中的复杂相互作用，并为癌症治疗找到新的靶点。本综述探讨了源自M2细胞的外泌体在维持癌细胞干细胞属性中所扮演的关键角色。

Cancer stem cells (CSCs) constitute a specific subset of cells found within tumors that are responsible for initiating, advancing and resisting traditional cancer treatments. M2 macrophages, also known as alternatively activated macrophages, contribute to the development and progression of cancer through their involvement in promoting angiogenesis, suppressing the immune system, supporting tumor growth and facilitating metastasis. Exosomes, tiny vesicles released by cells, play a crucial role in intercellular communications and have been shown to be associated with cancer development and progression by influencing the immune response; thus, they may serve as markers for diagnosis and prognosis. Currently, investigating the impact of exosomes derived from M2 macrophages on the maintenance of CSCs is a crucial area of research with the aim of developing novel therapeutic strategies to target this process and improve outcomes for individuals with cancer. Understanding the biological functions of exosomes derived from M2 macrophages and their involvement in cancer may lead to the formulation of novel diagnostic tools and treatments for this disease. By targeting M2 macrophages and the exosomes they secrete, promising prospects emerge for cancer treatment, given their substantial contribution to cancer development and progression. Further research is required to fully grasp the intricate interactions between CSCs, M2 macrophages and exosomes in cancer, and to identify fresh targets for cancer therapy. The present review explores the pivotal roles played by exosomes derived from M2 cells in maintaining the stem‑like properties of cancer cells.