外泌体的提取和鉴定及其在肾癌中的作用

doi:10.3969/j.issn.1673-8640.2025.11.016

摘要/Abstract

摘要：

肾癌是泌尿系统常见肿瘤。外泌体参与细胞间通讯、肿瘤细胞免疫逃逸、血管生成、转移和耐药等多个肿瘤发生、发展环节。外泌体在肾癌早期诊断、治疗和预后评估中具有重要作用，临床应用前景良好。文章介绍了外泌体的分离、提取和鉴定方法，阐述了外泌体在肾癌中的作用及其机制，以及外泌体在肾癌诊断、治疗和预后中的作用。

关键词: 外泌体, 生物标志物, 肾癌

Abstract:

Renal cancer is a common tumor in the urinary system. Exosomes participate in various aspects of tumor occurrence and development，such as intercellular communication，immune escape of tumor cells，angiogenesis，metastasis and drug resistance. Exosomes play an important role and have a promising clinical application prospect in the early diagnosis，treatment and prognosis assessment of renal cancer. This review introduces the methods for isolating，extracting and identifying exosomes，elaborates on the role and mechanism of exosomes in renal cancer and their functions in the diagnosis，treatment and prognosis of renal cancer.

Key words: Exosome, Biomarker, Renal cancer

中图分类号:

R446

董奕涵, 刘士铭, 王勇, 岳丹, 王蕊. 外泌体的提取和鉴定及其在肾癌中的作用[J]. 检验医学, 2025, 40(11): 1118-1125.

DONG Yihan, LIU Shiming, WANG Yong, YUE Dan, WANG Rui. Research progress of exosome extraction and identification in renal cancer[J]. Laboratory Medicine, 2025, 40(11): 1118-1125.

图/表 1

参考文献 57

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分离技术	分离原理	优点	缺点	试剂盒/开发平台
UC	基于外泌体大小、密度差异进行分离	适合大批量样本，无需特殊试剂	耗时长，成本高，纯度较低，易损伤外泌体	无
密度梯度离心法	基于外泌体大小、密度差异进行分离	可保持外泌体活性和形态，纯度较高	工作量大，操作复杂，耗时长，不适合大批量样本	无
PEG沉淀法	根据化合物与外泌体的理化特性，利用共沉淀或反向筛选进行分离	操作简单，耗时短，无设备限制	纯度较低，存在假阳性，可能破坏外泌体，干扰下游分析	ExoQuic（美国System Biosciences公司）、ExoPerp（爱沙尼亚HansaBioMed公司）
免疫亲和法	根据外泌体膜表面抗原与抗体特异性结合	纯度较高，特异性和重复性好，操作简便，无设备限制	不适合大批量样本，可能破坏外泌体，成本高	CUSABIO（武汉华美公司）
超滤法	根据外泌体粒子粒径进行分离	耗时短，操作简便	分离效率和纯度较低，影响外泌体形态	ExoMir Kit（美国Bio Scientific公司）
SEC	根据外泌体粒子粒径进行分离	纯度较高，操作简便，不影响外泌体结构	耗时长，容易损失，需要特殊设备	Exo-Spin（英国CellGuidance Systems公司）、Exosupur（北京恩泽康泰公司）
微流控技术	根据外泌体粒径大小、动力学、免疫亲和性进行分离	操作简便，纯度较高，不影响外泌体形态	不适合大批量样本，应用较少	EXODUS系统（清华大学蛋白质研究技术中心）^[6]、KeyPLEX系统（美国马萨诸塞州总医院系统生物学中心）^[7]
磁分离	通过附着外泌体表面特异性生物标志物的肽或抗体的磁珠进行分离	尿外泌体高通量分离，形式更完整，稳定表达特征蛋白	不能同时实现外泌体分离和定量测定	EVrich外泌体分离系统（南京逸微健华公司）^[8]
基于适配子的分离	通过与结构化的寡核苷酸序列结合进行分离	连续富集尿液外泌体并提取其代谢特征，具有高特异性和亲和力	无	适配体偶联多态碳材料CoMPCAu-Apt（复旦大学）^[9]

分离技术	分离原理	优点	缺点	试剂盒/开发平台
UC	基于外泌体大小、密度差异进行分离	适合大批量样本，无需特殊试剂	耗时长，成本高，纯度较低，易损伤外泌体	无
密度梯度离心法	基于外泌体大小、密度差异进行分离	可保持外泌体活性和形态，纯度较高	工作量大，操作复杂，耗时长，不适合大批量样本	无
PEG沉淀法	根据化合物与外泌体的理化特性，利用共沉淀或反向筛选进行分离	操作简单，耗时短，无设备限制	纯度较低，存在假阳性，可能破坏外泌体，干扰下游分析	ExoQuic（美国System Biosciences公司）、ExoPerp（爱沙尼亚HansaBioMed公司）
免疫亲和法	根据外泌体膜表面抗原与抗体特异性结合	纯度较高，特异性和重复性好，操作简便，无设备限制	不适合大批量样本，可能破坏外泌体，成本高	CUSABIO（武汉华美公司）
超滤法	根据外泌体粒子粒径进行分离	耗时短，操作简便	分离效率和纯度较低，影响外泌体形态	ExoMir Kit（美国Bio Scientific公司）
SEC	根据外泌体粒子粒径进行分离	纯度较高，操作简便，不影响外泌体结构	耗时长，容易损失，需要特殊设备	Exo-Spin（英国CellGuidance Systems公司）、Exosupur（北京恩泽康泰公司）
微流控技术	根据外泌体粒径大小、动力学、免疫亲和性进行分离	操作简便，纯度较高，不影响外泌体形态	不适合大批量样本，应用较少	EXODUS系统（清华大学蛋白质研究技术中心）^[6]、KeyPLEX系统（美国马萨诸塞州总医院系统生物学中心）^[7]
磁分离	通过附着外泌体表面特异性生物标志物的肽或抗体的磁珠进行分离	尿外泌体高通量分离，形式更完整，稳定表达特征蛋白	不能同时实现外泌体分离和定量测定	EVrich外泌体分离系统（南京逸微健华公司）^[8]
基于适配子的分离	通过与结构化的寡核苷酸序列结合进行分离	连续富集尿液外泌体并提取其代谢特征，具有高特异性和亲和力	无	适配体偶联多态碳材料CoMPCAu-Apt（复旦大学）^[9]