Exosomes in early detection of urological Cancer

Exosomes are potential biomarkers for liquid biopsy. Liquid biopsy is a minimally invasive technique that utilizes biofluid samples rather than tissue samples for cancer diagnosis. Exosomes are acknowledged as critical small extracellular vesicles released by all types of cells, facilitating intercellular communication in health and playing a role in various physiological and pathological processes by delivering cellular materials such as functional proteins, metabolites, and nucleic acids to recipient cells. Exosomes significantly contribute to the modulation of the tumor microenvironment (TME) through intercellular communication. As key immune stromal cells within the TME, tumor-associated macrophages (TAMs) play a vital role in tumor progression by promoting angiogenesis, metastasis, chemoresistance, and immune evasion. Urinary exosomes (uEVs) offer a promising, non-invasive approach for the diagnosis and management of urological cancers. Their molecular contents provide valuable information for early disease detection and monitoring. Urine's accessibility and abundance enhance its suitability as a diagnostic fluid; however, challenges such as the lack of standardized protocols and exosome heterogeneity hinder clinical translation. Advances in microfluidics, biosensors, and AI-driven analytics may help address these limitations. Ultimately, standardization and large-scale validation are essential for integrating urinary exosome-based assays into precision oncology and liquid biopsy frameworks. This review consolidates the knowledge regarding exosomes, which holds considerable significance for advancing research into the clinical diagnosis of urological cancers.