丁雨钦　邹德宏　何向明

[摘要] 外泌体是一类由自体细胞分泌的纳米级囊泡样小体，参与细胞及内环境之间的物质运输和信号传递。外泌体可以通过在肿瘤细胞和细胞外基质间运输细胞内的核酸、蛋白和脂类等物质，影响肿瘤的发生和发展，甚至可以影响肿瘤的治疗。不同类型的肿瘤细胞分泌的外泌体，在肿瘤的发生过程中发挥着不同的作用。近来，与乳腺癌相关的外泌体逐渐成为一项新的研究热点，并发现乳腺癌细胞可以刺激分泌某些特定类型的外泌体，并有望成为早期乳腺癌筛查的新型生物学标志。外泌体传递的核酸、蛋白质等物质在乳腺癌的发生、转移和治疗耐药中起到了重要作用。同时外泌体也可以将抗肿瘤药物转运出乳腺癌细胞导致耐药。但外泌体作为肿瘤药物载体时，表现出极低的免疫原性和生物毒性，将为今后的肿瘤靶向治疗提供可行的技术基础。

[关键词] 外泌体；乳腺癌；肿瘤转移；药物耐受；肿瘤微环境；生物学标记

[中图分类号] R737.9 [文献标识码] A [文章编号] 1673-9701（2017）19-0159-05

[Abstract] Exosomes are a kind of nanoscale vesicle-like body secreted by autologous cells， which are involved in the transport and signal transmission between cells and internal environment. Exosomes can affect the occurrence and development of tumors and can even affect the treatment of tumors by transporting intracellular substances including nucleic acids， proteins and lipids between tumor cells and extracellular matrix.Exosomes secreted by different types of tumor cells play different roles in the process of tumorigenesis. Recently， breast cancer-related exosomes have gradually become a new research hot spot and it is found that breast cancer cells can stimulate the secretion of certain types of exosomes， which are expected to become a new biological marker of early breast cancer screening. Substances including nucleic acids and proteins transferred by exosomes play an important role in the occurrence of breast cancer， metastasis and treatment of drug resistance.Meanwhile， exosomes can also transported anti-tumor drugs out of breast cancer cells to lead to drug resistance. However， when exosomes are used as tumor drug carriers， they exhibit very low immunogenicity and biotoxicity， and will provide a viable technical basis for future targeted tumor therapy.

[Key words] Exosomes； Breast cancer； Tumor metastasis； Drug tolerance； Tumor microenvironment； Biological markers

乳腺癌作為一类女性多发恶性肿瘤，在中国地区的发病率达到25.89/10万，约占所有女性恶性肿瘤发病率的16.83%。目前对于乳腺癌的临床诊断方法主要包括：临床体检、影像学检查、血清肿瘤标志物等，但这些检查手段的特异性和敏感性往往都不能令人满意，容易导致漏诊早期的乳腺癌，这也成为导致乳腺癌患者预后不良的重要因素之一。为寻找一些敏感可靠的诊断标志物，近年来关于乳腺癌的分子生物学研究逐渐成为热门。……