Exosomes are extracellular vesicles with a diameter of 30–100 nm that exist stably in various body fluids, including the blood, cerebrospinal fluid, urine, saliva, and serous cavity effusion. Compared with other vesicles, exosomes have a unique double-layer saclike structure and an endosomal origin. Depending on the physiological state of donor cells, there is heterogeneity in the bioactive substances present in exosomes, including proteins, RNA, DNA, lipids, and metabolites, providing a rich source of potential biomarkers for disease diagnosis. In head and neck cancer (HNC), exosomes have applications in disease diagnosis and prognosis based on liquid biopsy. Nonetheless, the functions and mechanisms of exosomes in HNC still remain unclear. Recent studies have elucidated the substances and signals transmitted between cancer cells using exosomes and have discussed tumor occurrence, development, metastasis, immune regulation, and drug resistance regulated by exosomes in HNC. In this review, we discuss these recent findings and highlight the significant role of exosomes in HNC, with a focus on the mechanism of tumor progression and the potential clinical value of exosomes as biomarkers and therapeutic targets.

外泌体是直径30-100 nm的细胞外囊泡，稳定存在于各种体液中，包括血液，脑脊液，尿液，唾液和浆液腔积液。与其他囊泡相比，外泌体具有独特的双层囊状结构和内体来源。根据供体细胞的生理状态，外泌体中存在的生物活性物质（包括蛋白质，RNA，DNA，脂质和代谢产物）存在异质性，为疾病诊断提供了丰富的潜在生物标记物来源。在头颈癌（HNC）中，外来体在基于液体活检的疾病诊断和预后中具有应用。尽管如此，HNC中外来体的功能和机制仍不清楚。最近的研究阐明了利用外泌体在癌细胞之间传递的物质和信号，并讨论了肿瘤的发生，发展，转移，免疫调节以及外泌体在HNC中调节的耐药性。在这篇综述中，我们讨论了这些最新发现，并强调了外泌体在HNC中的重要作用，重点是肿瘤进展的机制以及外泌体作为生物标志物和治疗靶标的潜在临床价值。