Cancer Genetics and Epigenetics, 2025, Vol.13, No.3, 106-116 http://medscipublisher.com/index.php/cge 109 The stability and wide presence of exosomes make them reliable carriers of tumor markers. People can conduct cancer detection and disease monitoring through minimally invasive and multiple sampling methods (Breakefield et al., 2021). Compared with traditional tissue biopsy, isolating exosomes from easily accessible body fluids is more convenient for application in daily clinical work and can also make patients more comfortable (Jafarbeik-Iravani et al., 2017; Song et al., 2020; Cai et al., 2022; Wang et al., 2025). 4.2 The value of exosome biomarkers in the early detection and classification of cancers Biomarkers such as proteins, micrornas and other nucleic acids in exosomes have high diagnostic value in the early detection and type differentiation of various cancers such as lung cancer, breast cancer and pancreatic cancer (Zhu et al., 2020; Tusubira et al., 2022; Wang et al., 2025). For instance, through the micrornas and proteins in exosomes, cancer patients and healthy individuals can be distinguished, and the type and stage of tumors can also be determined, which is conducive to early treatment and the formulation of personalized plans (Jafarbeik-Iravani et al., 2017; Qin et al., 2018; Kang et al., 2020; Tusubira et al., 2022). When diagnosing pancreatic cancer, compared with other methods, liquid biopsy based on exosomes is more sensitive (0.93), has higher specificity (0.92), and the area under the curve (AUC) reaches 0.98, with very outstanding diagnostic accuracy (Zhu et al., 2020). Similarly, in the diagnosis of lung cancer and breast cancer, exosome markers can also achieve early detection and classification. Combined with deep learning and advanced spectroscopy techniques, the diagnostic effect will be better (Jafarbeik-Iravani et al., 2017; Qin et al., 2018; Kang et al., 2020). 4.3 Advantages over traditional tissue biopsy in terms of sensitivity and real-time monitoring Compared with traditional tissue biopsy, liquid biopsy based on exosomes has many obvious advantages. It is more sensitive in detecting tumor signals and can also grasp the tumor development and treatment effect in real time and dynamically (Jafarbeik-Iravani et al., 2017; Song et al., 2020; Kang et al., 2020; Breakefield et al., 2021; Tusubira et al., 2022). Tissue biopsy is not only invasive but also limited by tumor differences and inaccurate sampling. However, exosome analysis can reflect the tumor situation more comprehensively from multiple sites and stages (Figure 1) (Cai et al., 2022; Wang et al., 2025). Figure 1 Exosomal biomarkers of systemic tumors, application in tumors of different systems and some examples of biomarkers (Adopted from Wang et al., 2025)
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