Cancer Genetics and Epigenetics, 2025, Vol.13, No.3, 106-116 http://medscipublisher.com/index.php/cge 106 Research Insights Open Access Diagnostic Potential and Mechanisms of Tumor-Derived Exosomes in Liquid Biopsy Xiaopen Liu, Jie Zhang Institute of Life Science, Jiyang College of Zhejiang A&F University, Zhuji, 311800, Zhengjiang, China Corresponding author: jie.zhang@jicat.org Cancer Genetics and Epigenetics, 2025, Vol.13, No.3 doi: 10.5376/cge.2025.13.0011 Received: 10 Mar., 2025 Accepted: 21 Apr., 2025 Published: 09 May, 2025 Copyright © 2025 Liu and Zhang, This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Preferred citation for this article: Liu X.P., and Zhang J., 2025, Diagnostic potential and mechanisms of tumor-derived exosomes in liquid biopsy, Cancer Genetics and Epigenetics, 13(3): 106-116 (doi: 10.5376/cge.2025.13.0011) Abstract This study deeply analyzed the biological characteristics, mechanism of action and diagnostic advantages of TEXs in liquid biopsy, and simultaneously explored their influences in the processes of tumor deterioration, immune escape and the development of drug resistance, as well as their potential as biomarkers for the early detection, classification and real-time monitoring of cancer. Nowadays, new technologies for exosome separation and detection, such as microfluidics, biosensors, and analysis with the aid of artificial intelligence, are constantly emerging, which are driving their rapid development towards clinical applications. Although there are still difficulties in unifying standards and clinical promotion, TEXs is expected to promote the development of precision oncology and revolutionize the cancer diagnosis model with its minimally invasive detection technology. Keywords Tumor-derived exosomes; Liquid biopsy; Cancer biomarkers; Non-invasive diagnostics; Exosome technology 1 Introduction Liquid biopsy has rapidly become an important new method for cancer diagnosis. By analyzing biological body fluids such as blood, urine and saliva, it provides minimally invasive and timely tumor-derived substances. This technology can achieve early detection, formulate treatment plans based on the condition, monitor residual lesions and recurrence, and solve many deficiencies of traditional tissue biopsy, such as invasiveness and inaccurate sampling. Driven by the potential to improve cancer detection, prognosis assessment and personalized treatment strategies for various malignant tumors, the clinical application of liquid biopsy is continuously expanding (Song et al., 2020;Breakefield et al., 2021; Valencia and Montuenga, 2021; Cai et al., 2022; Jiang et al., 2022). Exosomes are a type of extracellular vesicles, ranging in size from 30 to 150 nanometers. Almost all cell types, including tumor cells, secrete exosomes, and they are abundant in body fluids. These nanovesicles contain a variety of biomolecules-DNA, RNA, proteins, lipids and metabolites-reflecting the molecular characteristics of the cells from which they originate. Because exosomes have a lipid bilayer structure, they are very stable in circulation, making them reliable carriers of tumor-specific information. Exosomes can reflect the genetic and signaling changes of tumor cells. Combined with their roles in intercellular information transmission and participation in the process of cancer development, they become highly potential biomarkers in liquid biopsy. Furthermore, compared with other circulating biomarkers (such as cell-free DNA and circulating tumor cells), they have obvious advantages in terms of stability, richness and multi-component analysis ability (Qin et al., 2018; Fitts et al., 2019; Song et al., 2020; Breakefield et al., 2021; Valencia and Montuenga, 2021; Cai et al., 2022). This study will comprehensively analyze the diagnostic potential of tumor-derived exosomes and the underlying mechanisms in the context of liquid biopsy. By integrating the latest developments in exosome isolation, molecular analysis and detection techniques, this article will focus on how exosomes can be applied in early cancer detection, disease monitoring and prognosis assessment. This article will also discuss the biological roles of exosomes in tumor progression and intercellular communication, as well as the challenges and future development directions faced in applying exosome-based liquid biopsy to clinical practice.
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