Extracellular vesicles as biomarkers for endometrial cancer – A systematic review

IF 5 2区医学 Q2 Medicine

Translational Oncology Pub Date : 2025-09-22 DOI:10.1016/j.tranon.2025.102543

Eva Baxter , Soumyalekshmi Nair , Zoe West , Carlos Salomon , Andreas Obermair

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Abstract

Background

The current method for diagnosing endometrial cancer and monitoring treatment response is invasive and fraught with both interobserver and intraobserver variability. Less invasive and more reproducible methods are desirable. This systematic review examines the evidence for extracellular vesicles as minimally invasive biomarkers for endometrial cancer.

Methods

PubMed, Embase and Web of Science were searched for studies reporting extracellular vesicles as biomarkers in females with endometrial cancer. Risk of bias was assessed using the QUADAS-2 tool. A descriptive synthesis of biomarkers reported in the included studies was conducted.

Results

Of the 680 unique records reviewed, 23 studies were included. All 23 studies investigated extracellular vesicles as diagnostic biomarkers. Ten extracellular vesicle-associated biomarkers were consistently reported to be differentially abundant between endometrial cancer cases and controls in multiple independent studies and hence may be putative diagnostic biomarkers. Levels of extracellular vesicles, LGALS3BP (galectin 3 binding protein), miR-15a-5p, and miR-21–3p were elevated, while levels of miR-26a-5p, miR-130a-3p, miR-139, miR-219a-5p, miR-222–3p, and miR-885 were decreased in endometrial cancer cases versus controls. Seven studies also investigated extracellular vesicles as prognostic biomarkers, but no biomarker was reported as prognostic in more than one study.

Conclusion

Of the ten putative diagnostic biomarkers, extracellular vesicle-associated miR-21–3p, miR-26a-5p, miR-130a-3p, miR-139 and miR-219a-5p are the most promising as their expression in extracellular vesicle preparations appears to reflect that in endometrial tissue. However, there are significant concerns regarding study quality, limited adherence to consensus recommendations on extracellular vesicle research and lack of evidence supporting biomarkers being encapsulated within extracellular vesicles.

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细胞外囊泡作为子宫内膜癌的生物标志物——系统综述

目前诊断子宫内膜癌和监测治疗反应的方法是侵入性的，并且充满了观察者之间和观察者内部的可变性。侵入性更小、可重复性更强的方法是可取的。本系统综述探讨了细胞外囊泡作为子宫内膜癌微创生物标志物的证据。方法检索spubmed、Embase和Web of Science中报道细胞外囊泡作为子宫内膜癌女性生物标志物的研究。使用QUADAS-2工具评估偏倚风险。对纳入研究中报道的生物标志物进行描述性合成。结果在回顾的680个独特记录中，包括23个研究。所有23项研究都将细胞外囊泡作为诊断性生物标志物。在多个独立研究中，十种细胞外囊泡相关的生物标志物在子宫内膜癌病例和对照组之间的含量差异一致，因此可能是推定的诊断性生物标志物。与对照组相比，子宫内膜癌患者的细胞外囊泡、LGALS3BP（凝集素3结合蛋白）、miR-15a-5p和miR-21-3p水平升高，而miR-26a-5p、miR-130a-3p、miR-139、miR-219a-5p、miR-222-3p和miR-885水平降低。7项研究还研究了细胞外囊泡作为预后生物标志物，但没有一项以上的研究报道了生物标志物作为预后。在10种推测的诊断性生物标志物中，细胞外囊泡相关的miR-21-3p、miR-26a-5p、miR-130a-3p、miR-139和miR-219a-5p是最有希望的，因为它们在细胞外囊泡制剂中的表达似乎反映了子宫内膜组织中的表达。然而，在研究质量、对细胞外囊泡研究的一致建议的有限遵守以及缺乏支持细胞外囊泡内包裹生物标志物的证据方面存在重大问题。

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来源期刊

Translational Oncology ONCOLOGY-

CiteScore

8.40

自引率

2.00%

发文量

314

审稿时长

54 days

期刊介绍： Translational Oncology publishes the results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of oncology patients. Translational Oncology will publish laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer. Peer reviewed manuscript types include Original Reports, Reviews and Editorials.