[Research Progress of Exosomes in Lung Cancer Diagnosis and Treatment]

Advancements and trends in exosome research in lung cancer from a bibliometric analysis (2004-2023)

Background

Lung cancer, characterized by its high morbidity and lethality, necessitates thorough research to enhance our understanding of its pathogenesis and discover novel therapeutic approaches. Recent studies increasingly demonstrate that lung cancer cells can modulate the tumor microenvironment, promoting tumor growth, and metastasis through the release of exosomes. Exosomes are small vesicles secreted by cells and contain a variety of bioactive molecules such as proteins, nucleic acids, and metabolites. This paper presents a comprehensive review of exosome research in lung cancer and its progress through bibliometric analysis.

Methods

Publications related to exosomes in lung cancer patients were systematically searched on the Web of Science Core Collection (WoSCC) database. Bibliometric analysis was performed using VOSviwers, CiteSpace, and the R package "Bibliometrics". Publications were quantitatively analyzed using Microsoft Office Excel 2019. The language of publication was restricted to "English" and the search strategy employed TS=(exosomes or exosomes or exosomes) and TS=(lung cancer). The search period commenced on January 1, 2004, and concluded on November 12, 2023, at noon. The selected literature types included Articles and Reviews.

Results

The study encompassed 1699 papers from 521 journals across 71 countries and 2105 institutions. Analysis revealed a consistent upward trend in lung cancer exosome research over the years, with a notable surge in recent times. This surge indicates a growing interest and depth of inquiry into lung cancer exosomes. Major research institutions in China and the United States, including Nanjing Medical University, Shanghai Jiao Tong University, Chinese Academy Of Sciences, and Utmd Anderson Cancer Center, emerged as crucial research hubs. The annual publication count in this field witnessed a continuous rise, particularly in recent years. Key terms such as lung cancer, non-small cell lung cancer (NSCLC), microvesicles, intercellular communication, exosomal miRNAs, and oncology dominated the research landscape. Fields like cell biology, biochemistry, biotechnology, and oncology exhibited close relation with this research. Clotilde Théry emerged as the most cited author in the field, underlining her significant contributions. These results demonstrate the broad impact of exosome research in lung cancer, with key terms covering not only disease-specific aspects such as lung cancer and NSCLC but also basic biological concepts like microvesicles and intercellular communication. Explorations into exosomal microRNAs and oncology have opened new avenues for lung cancer exosome research. In summary, lung cancer exosome research is poised to continue receiving attention, potentially leading to breakthroughs in treatment and prevention.

Conclusion

Publications on lung cancer exosomes show a rising trend year by year, with China and the United States ranking first and second in terms of the number of publications. However, there is insufficient academic learning cooperation and exchanges between the two sides, and Chinese universities account for a large proportion of research institutions in this field. Jing Li is the most productive author, Clotilde Théry is the most co-cited author, and Cancers is the journal with the highest number of publications. The current focus in the field of lung cancer exosomes is on biomarkers, liquid biopsies, immunotherapy, and tumor microenvironment.

The diagnostic accuracy of liquid exosomes for lung cancer detection: a meta-analysis

PURPOSE

Several studies have suggested that liquid exosomes can be used as biomarkers for the diagnosis of lung cancer (LC). The purpose of this meta-analysis was to investigate the comprehensive diagnostic value of liquid exosomes for LC.

MATERIALS AND METHODS

Relevant studies were searched from multiple electronic databases. The quality of the studies was assessed by the Quality Assessment of Diagnostic Accuracy Studies-2 criteria in RevMan 5.3 software. Stata 14.0 software and Meta-disc 1.4 software were used to synthesize the diagnostic parameters. Publication bias was judged according to the Deeks' funnel plot asymmetry test.

RESULTS

There were 13 eligible articles that comprised 1,338 LC patients and 1,075 paired controls for the meta-analysis. The pooled sensitivity (SEN), specificity (SPE), diagnostic likelihood ratio positive (DLR+), diagnostic likelihood ratio negative (DLR-), diagnostic OR (DOR), and area under the curve (AUC) of liquid exosomes in diagnosing LC were 0.82 (95% CI: 0.76-0.87), 0.84 (95% CI: 0.77-0.89), 5.27 (95% CI: 3.58-7.75), 0.21 (95% CI: 0.15-0.29), 25.14 (95% CI: 14.25-44.33), and 0.90 (95% CI: 0.87-0.92), respectively. Research based on serum, miRNA, the isolation kit method, one index in exosomes, patient sample size of 50 or greater, and control group size of 50 or greater obtained higher AUC values when the LC type was small cell lung cancer.

CONCLUSION

Liquid exosomes have shown potential as novel biomarkers that could facilitate LC diagnosis. Further prospective studies are still needed to confirm the diagnostic value of liquid exosomes.