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World J Gastroenterol. Nov 14, 2023; 29(42): 5699-5715
Published online Nov 14, 2023. doi: 10.3748/wjg.v29.i42.5699
Role of exosomes in metastasis and therapeutic resistance in esophageal cancer
Xing-Yu Ning, Jin-Hu Ma, Wei He, Jun-Ting Ma
Xing-Yu Ning, Jin-Hu Ma, The Second School of Clinical Medicine, Anhui Medical University, Hefei 230032, Anhui Province, China
Wei He, Jun-Ting Ma, School of Basic Medical Sciences, Anhui Medical University, Hefei 230032, Anhui Province, China
Author contributions: Ning XY and Ma JH wrote the manuscript and created the tables and figures; He W and Ma JT revised critically the manuscript.
Supported by the Natural Science Foundation of China, No. 82003048 and No. 82203284; Joint Project of Natural Science Foundation of China, No. U22A2038; Anhui Provincial Natural Science Foundation, No. 1908085QC131 and No. 2008085QH377; Research Improvement Program of Anhui Medical University, No. 2021xkjT002; and Undergraduate Innovation and Entrepreneurship Training Program of Anhui Medical University, No. S202210366044.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Ting Ma, Doctor, Lecturer, School of Basic Medical Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui Province, China. 1064363840@qq.com
Received: June 16, 2023
Peer-review started: June 16, 2023
First decision: August 31, 2023
Revised: September 13, 2023
Accepted: November 8, 2023
Article in press: November 8, 2023
Published online: November 14, 2023
Processing time: 149 Days and 23.5 Hours
Abstract

Esophageal cancer (EC) has a high incidence and mortality rate and is emerging as one of the most common health problems globally. Owing to the lack of sensitive detection methods, uncontrollable rapid metastasis, and pervasive treatment resistance, EC is often diagnosed in advanced stages and is susceptible to local recurrence. Exosomes are important components of intercellular communication and the exosome-mediated crosstalk between the cancer and surrounding cells within the tumor microenvironment plays a crucial role in the metastasis, progression, and therapeutic resistance of EC. Considering the critical role of exosomes in tumor pathogenesis, this review focused on elucidating the impact of exosomes on EC metastasis and therapeutic resistance. Here, we summarized the relevant signaling pathways involved in these processes. In addition, we discussed the potential clinical applications of exosomes for the early diagnosis, prognosis, and treatment of EC.

Keywords: Exosomes; Esophageal cancer; Tumor microenvironment; Metastasis; Signaling pathway; Therapeutic resistance

Core Tip: Esophageal cancer (EC) is a highly malignant type of cancer, and its early diagnosis and effective treatment are lacking. We highlighted the following: (1) Exosomes are involved in altering the number or function of cells in the tumor microenvironment of EC; (2) all steps of EC metastasis and various therapeutic resistance are closely related to exosomes; and (3) exosomes can serve as reliable biomarkers and effective treatment tools for EC. Finally, we presented the urgent challenges and described the future research directions for exosome application in the diagnosis and treatment of EC.