Functions and mechanisms of exosomal lncRNAs in esophageal cancer

Esophageal cancer is a prevalent and highly aggressive malignancy with poor clinical outcomes, largely due to late diagnosis and limited effective biomarkers. Improved understanding of its molecular mechanisms and the identification of reliable non-invasive diagnostic indicators are therefore of critical importance. Exosomes are small double-membrane extracellular vesicles present in various biological fluids that mediate intercellular communication through the transfer of bioactive cargo, including proteins and RNAs. Among these cargos, long non-coding RNAs (lncRNAs) packaged within exosomes have emerged as key regulators of tumor initiation, progression, metastasis, and therapeutic resistance. Increasing evidence indicates that exosomal lncRNAs play crucial roles in esophageal cancer by modulating cell proliferation, migration, invasiveness, angiogenesis, and response to treatment, while also exhibiting high stability in circulation, making them promising diagnostic and prognostic biomarkers. This review summarizes recent advances in the biological functions, clinical relevance, and translational potential of exosomal lncRNAs in esophageal cancer, highlighting their emerging value in liquid biopsy and targeted therapeutic strategies.