Affiliations
1Cancer Science Institute of Singapore, National University of Singapore, Singapore 117599, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore.
2Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, Shanghai 20203, China.
3Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
4Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore; Department of Haematology-Oncology, National University Cancer Institute, Singapore 119228, Singapore.
5Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore 138673, Singapore.
6Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
7Cancer Science Institute of Singapore, National University of Singapore, Singapore 117599, Singapore; Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: csiwl@nus.edu.sg.
8Cancer Science Institute of Singapore, National University of Singapore, Singapore 117599, Singapore; Department of Haematology-Oncology, National University Cancer Institute, Singapore 119228, Singapore. Electronic address: csilsc@nus.edu.sg.
9Cancer Science Institute of Singapore, National University of Singapore, Singapore 117599, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore; Department of Haematology-Oncology, National University Cancer Institute, Singapore 119228, Singapore; Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: phcgbc@nus.edu.sg.
Abstract
Cancer has risen up to be a major cause of mortality worldwide over the past decades. Despite advancements in cancer screening and diagnostics, a significant number of cancers are still diagnosed at a late stage with poor prognosis. Hence, the discovery of reliable and accurate methods to diagnose cancer early would be of great help in reducing cancer mortality. Extracellular vesicles (EVs) are phospholipid vesicles found in many biofluids and are released by almost all types of cells. In recent years, using EVs as cancer biomarkers has garnered attention as a novel technique of cancer diagnosis. Compared with traditional tissue biopsy, there are many advantages that this novel diagnostic tool presents – it is less invasive, detects early-stage asymptomatic cancers, and allows for monitoring of tumour progression. As such, EV biomarkers have great potential in improving the diagnostic accuracy of cancers and guiding subsequent therapeutic decisions. Efficient isolation and accurate characterization of EVs are essential for reliable outcomes of clinical application. However, these are complicated by the size and biomolecular diversity of EVs. In this review, we present an analysis and evaluation of the current techniques of EV isolation and characterization, as well as discuss the potential EV biomarkers for specific types of cancer. Taken together, EV biomarkers have a lot of potential as a novel method in cancer diagnostics and diagnosis. However, more work is still needed to streamline the purification, characterization and biomarker identification process to ensure optimal outcomes for patients.
Keywords: Cancer biomarker; EV characterization; EV isolation; Extracellular vesicles; Liquid biopsy.
Copyright © 2021 Elsevier Ltd. All rights reserved.
PMID: 33989735 DOI: 10.1016/j.semcancer.2021.05.011