外泌体即时检测技术在肿瘤液体活检中的研究进展OA

Tumor-derived exosomes carry nucleic acids,proteins,lipids,and other molecular information inherited from their parental cells,allowing them to dynamically reflected tumor initiation,progression,molecular subtype,and therapeutic response.They were therefore promising biomarkers for noninvasive liquid biopsy.Nevertheless,point-of-care analysis of tumor-derived exosomes remained technically challenging because these vesicles were present at low abundance in body fluids,coexist with abundant proteins,lipoproteins,and cell debris,and exhibit substantial molecular heterogeneity.These features placed stringent requirements on enrichment efficiency,recognition specificity,signal amplification,analytical stability,and operational simplicity.This review summarized recent advances in point-of-care testing(POCT)technologies for tumor exosomes.First,the major analytical bottlenecks imposed by microliter-scale samples,complex biological matrices,and non-standard operating environments were discussed.The available approaches were then organized from two complementary perspectives:signal-transduction mechanisms and device-integration platforms.Colorimetric,fluorescence,surface-enhanced Raman scattering,and electrochemical sensing were reviewed with emphasis on their recognition and amplification principles,whereas microfluidic chips and paper-based analytical devices were discussed as integrated platforms for sample pretreatment,exosome enrichment,reaction control,and portable readout.Their representative performance was further compared in terms of limit of detection,linear range,total assay time,cost,equipment dependence,operational complexity,and intended application.Colorimetric methods were generally suitable for rapid and low-cost screening,whereas fluorescence,electrochemical,and Raman-based approaches provided greater analytical sensitivity and multiplexing capability but often required additional labels or dedicated readers.Microfluidic platforms offered automated fluid handling and high integration,while paper-based devices provide low-cost operation and broad accessibility,particularly in resource-limited settings.Particular attention was paid to multi-target detection,dual-recognition logic gates,spatially encoded assays,and orthogonal protein-nucleic acid validation,which could reduce false-positive results and improve the discrimination of tumor-derived exosomes from vesicles released by normal cells.Clinical validation studies were subsequently reviewed by cancer type,including breast,lung,colorectal,and gastric cancers,highlighting differences in biomarker selection,sample type,sensing strategy,cohort size,and diagnostic performance.Finally,key barriers to clinical translation were discussed,including the lack of standardized isolation and quantification procedures,batch-to-batch variation and mass-production challenges for sensing devices,insufficient prospective multicenter validation,and limited evaluation under real-world clinical conditions.Future directions included multimodal signal fusion,artificial-intelligence-assisted interpretation,wearable and home-based testing,and single-exosome omics.Collectively,these developments might facilitate the transition of exosome POCT from laboratory proof-of-concept studies toward practical tools for cancer screening,molecular stratification,treatment-response assessment,and longitudinal monitoring.