外泌体的直径在 30 至 150 nm 之间，是由脂质双层膜包围的小囊泡。它们由体内的各种细胞释放，并携带多种分子有效负载，包括蛋白质、脂质、mRNA 和不同的 RNA 种类，例如长非编码 RNA、环状 RNA 和 microRNA (miRNA)。 miRNA 的长度约为 19-22 个核苷酸，构成外泌体中的主要货物，并作为蛋白质生物合成的关键调节因子。在癌症检测中，外泌体 miRNA 由于其稳定性和存在于各种体液中而有望成为非侵入性生物标志物，有助于利用与不同癌症类型相关的特定 miRNA 特征进行早期检测和精确诊断。此外，外泌体 miRNA 通过影响细胞生长、细胞死亡和耐药性等细胞过程来影响治疗结果，从而影响对治疗的反应。此外，它们还可以作为疾病进展和治疗反应的指标，提供可以指导治疗决策和改善患者护理的见解。通过纵向研究，观察到外泌体 miRNA 谱的变化与疾病进展、转移和治疗反应相关，突出了它们实时监测肿瘤动态和治疗效果的潜力。了解外泌体 miRNA 在癌症生物学中的复杂作用，为开发针对个体患者的创新诊断工具和治疗策略提供了机会，最终推进精准医疗方法并改善癌症患者的治疗结果。本综述旨在了解外泌体 miRNA 在癌症检测、治疗和监测中的作用，揭示其彻底改变肿瘤学实践和患者护理的潜力。© 2024。作者获得 Federación de 独家许可西班牙肿瘤学会 (FESEO)。

Exosomes, measuring between 30 and 150 nm in diameter, are small vesicles enclosed by a lipid bilayer membrane. They are released by various cells in the body and carry a diverse payload of molecules, including proteins, lipids, mRNA, and different RNA species such as long non-coding RNA, circular RNA, and microRNA (miRNA). With lengths of approximately 19-22 nucleotides, miRNAs constitute the predominant cargo in exosomes and serve as crucial regulators of protein biosynthesis. In cancer detection, exosomal miRNAs show promise as non-invasive biomarkers due to their stability and presence in various bodily fluids, aiding in early detection and precise diagnosis with specific miRNA signatures linked to different cancer types. Moreover, exosomal miRNAs influence treatment outcomes by affecting cellular processes like cell growth, cell death, and drug resistance, thereby impacting response to therapy. Additionally, they serve as indicators of disease progression and treatment response, providing insights that can guide treatment decisions and improve patient care. Through longitudinal studies, changes in exosomal miRNA profiles have been observed to correlate with disease progression, metastasis, and response to therapy, highlighting their potential for real-time monitoring of tumor dynamics and treatment efficacy. Understanding the intricate roles of exosomal miRNAs in cancer biology offers opportunities for developing innovative diagnostic tools and therapeutic strategies tailored to individual patients, ultimately advancing precision medicine approaches and improving outcomes for cancer patients. This review aims to provide an understanding of the role of exosomal miRNAs in cancer detection, treatment, and monitoring, shedding light on their potential for revolutionising oncology practices and patient care.© 2024. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).