Extracellular vesicles long RNA for cancer diagnosis and prognosis: a narrative review

Abstract

Background and Objective: Cancer is an aggressive disease and exhibits a low median survival rate. Accurate early diagnosis and prognosis prediction are essential to improve the patient's survival status. Extracellular vesicles (EVs), an emerging liquid biopsy, have shown promising performance in cancer diagnosis, tumor response prediction and treatment monitoring. The profiling of extracellular vesicle long RNAs (exLRs) was shown to be different in different physiological and pathological states. The review aims to provide a comprehensive overview of exLRs for cancer diagnosis and prognosis. Methods: Full-length manuscripts published until August 2022 gathered from PubMed were used to inform this review. Non-English publications and studies not related to oncology were excluded. Key Content and Findings: EVs are a heterogeneous group of double membrane structures that either originate from the endosomal system or are shed from the plasma membrane. ExLRs including mRNAs, lncRNAs and circRNAs, are abundant, stable and partially intact with the protection of membrane. They are also characterized as tissue-specific and show promise in cancer liquid biopsy. We highlight the current status and approaches of these exLRs in early diagnosis and treatment response assessment in oncology [e.g., breast cancer, lung cancer, colorectal cancer (CRC), hepatocellular carcinoma (HCC), prostate cancer (PCa), etc.]. In addition, the prospects and challenges of applying exLRs to precision medicine are discussed. Conclusions: ExLRs are becoming a valuable tool for cancer diagnosis and prognosis. Efficient and stable methods for standardized EV isolating and exLR detection are needed to enhance their application in clinical applications.