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已发表论文
骨肉瘤中的细胞外囊泡：机制、诊断及治疗应用
Authors Yin C, Wu Y, Qu X, Wu W, Zhang B, Chen J
Received 3 September 2025
Accepted for publication 29 November 2025
Published 6 January 2026 Volume 2026:20 565059
DOI https://doi.org/10.2147/DDDT.S565059
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Georgios Panos
Chaoyi Yin,* Yiqi Wu,* Xiliang Qu, Wenren Wu, Binshan Zhang, Jinshui Chen
Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Binshan Zhang, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, People’s Republic of China, Email 13600298950@163.com Jinshui Chen, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, People’s Republic of China, Email jinsonchen123@126.com
Abstract: Osteosarcoma is a primary bone malignancy of adolescents and young adults with marked heterogeneity and a high metastatic propensity. Five-year survival exceeds 70% in localized disease but falls to about 20% with pulmonary metastasis or chemoresistance, and overall outcomes have plateaued for decades. Extracellular vesicles (EVs) have emerged as critical mediators of osteosarcoma progression and metastasis. EVs remodel the tumor microenvironment (TME) by promoting immune evasion, extracellular matrix reprogramming, and angiogenesis, while also facilitating invasion, epithelial–mesenchymal transition (EMT)–like plasticity, and formation of lung pre-metastatic niches through organotropic integrins and glycoproteins. Their cargo, including proteins, lipids, and nucleic acids, drives intercellular communication that sustains proliferation, migration, and therapy resistance under metabolic or hypoxic stress. Clinically, the stability of EVs in body fluids and their tumor-specific molecular signatures highlight their promise as liquid-biopsy biomarkers for early diagnosis, prognosis, and treatment monitoring. Therapeutically, EVs are being engineered as delivery vehicles for drugs or RNA therapeutics, and interventions targeting their biogenesis, cargo sorting, or uptake are under exploration. Future research should integrate single-EV multi-omics, longitudinal cohort validation, and causal perturbation models to delineate functional mechanisms. Rational strategies that modulate EV dynamics and incorporate standardized analytic pipelines may transform EVs into actionable biomarkers and therapeutic targets, offering new avenues to overcome resistance and improve clinical outcomes in osteosarcoma.
Keywords: EVs, osteosarcoma, ncRNAs, TME, mechanisms, therapeutic strategies
Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Binshan Zhang, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, People’s Republic of China, Email 13600298950@163.com Jinshui Chen, Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan, People’s Republic of China, Email jinsonchen123@126.com
Abstract: Osteosarcoma is a primary bone malignancy of adolescents and young adults with marked heterogeneity and a high metastatic propensity. Five-year survival exceeds 70% in localized disease but falls to about 20% with pulmonary metastasis or chemoresistance, and overall outcomes have plateaued for decades. Extracellular vesicles (EVs) have emerged as critical mediators of osteosarcoma progression and metastasis. EVs remodel the tumor microenvironment (TME) by promoting immune evasion, extracellular matrix reprogramming, and angiogenesis, while also facilitating invasion, epithelial–mesenchymal transition (EMT)–like plasticity, and formation of lung pre-metastatic niches through organotropic integrins and glycoproteins. Their cargo, including proteins, lipids, and nucleic acids, drives intercellular communication that sustains proliferation, migration, and therapy resistance under metabolic or hypoxic stress. Clinically, the stability of EVs in body fluids and their tumor-specific molecular signatures highlight their promise as liquid-biopsy biomarkers for early diagnosis, prognosis, and treatment monitoring. Therapeutically, EVs are being engineered as delivery vehicles for drugs or RNA therapeutics, and interventions targeting their biogenesis, cargo sorting, or uptake are under exploration. Future research should integrate single-EV multi-omics, longitudinal cohort validation, and causal perturbation models to delineate functional mechanisms. Rational strategies that modulate EV dynamics and incorporate standardized analytic pipelines may transform EVs into actionable biomarkers and therapeutic targets, offering new avenues to overcome resistance and improve clinical outcomes in osteosarcoma.
Keywords: EVs, osteosarcoma, ncRNAs, TME, mechanisms, therapeutic strategies