[Mechanisms of Exosomes in Lung Cancer Bone Metastasis and Related Clinical Advances].

内容摘要

Lung cancer is the malignant tumor with the highest morbidity and mortality, and it is usually diagnosed with advanced metastasis. Tumor metastasis is an important factor affecting treatment resistance and poor prognosis of lung cancer, among which bone metastasis is a common metastatic pattern of lung cancer and is associated with a particularly dismal prognosis. Meanwhile, bone metastasis frequently causes skeletal-related events such as bone pain, pathological fractures, nerve compression, and hypercalcemia. Exosomes are extracellular vesicles with a diameter of 40-160 nm that are released from the fusion of intracellular multivesicular bodies and the cell membrane. Carrying proteins, lipids, and nucleic acids, they mediate communication between tumor cells and their surrounding matrix, immune cells, and the bone microenvironment. So, it has attracted increasing attention from researchers. This paper aims to summarize and organize the latest research advances on exosomes promoting lung cancer bone metastasis, focusing on their key mechanisms and signaling pathways. These include promoting tumor cells proliferation, invasion and metastasis at the primary lesion, as well as participating in energy metabolism reprogramming, pre-metastatic niche remodeling, immune microenvironment regulation, and interactions with osteocytes, stromal cells, and other cells during distant bone metastasis colonization. In addition, this review analyzes the potential clinical translational value of exosomes in the early diagnosis, treatment, and prognosis of lung cancer bone metastasis. 【中文题目：外泌体参与肺癌骨转移的机制研究
及其相关临床诊疗进展】 【中文摘要：肺癌是发病率和死亡率最高的恶性肿瘤，诊断时通常已形成晚期转移。肿瘤发生转移是其治疗效果差、生存期短的重要影响因素，其中骨转移是肺癌常见的转移形式，常引起骨痛、病理性骨折、神经压迫和高钙血症等骨相关事件，严重影响患者生活质量且预后极差。外泌体是由细胞内多囊泡体与细胞膜融合后，释放到细胞外形成的直径为40-160 nm的细胞外囊泡。其携带蛋白质、脂质和核酸等物质介导肿瘤细胞与基质细胞、免疫细胞及骨微环境之间的信息传递，在肿瘤发生发展及侵袭转移过程中发挥重要调控作用，因此日益受到研究者们的关注。本文旨在总结并梳理外泌体促进肺癌骨转移的最新研究进展，重点阐述其关键机制与信号通路，包括在原发灶促进肿瘤细胞增殖和侵袭转移，在远处骨转移定植过程中参与的能量代谢重编程、转移前微环境塑造、免疫微环境调控和骨细胞、基质细胞等互作，并进一步分析外泌体在肺癌骨转移早期诊断、治疗及预后等方面的潜在临床转化价值。
】 【中文关键词：外泌体；肺肿瘤；骨转移；诊疗】.