Pancreatic cancer has the worst prognosis among common tumors which is attributed to its aggressive phenotype, diagnosis at advanced, inoperable stages, and resistance to systemic therapy. Non-coding RNAs (ncRNAs) such as microRNAs, long non-coding RNAs, and circular RNAs have been established as important regulators of gene expression and their deregulation has been implicated in multiple diseases and foremost cancer. In the tumor microenvironment, non-coding RNAs can be distributed among cancer cells, stromal cells, and immune cells via small extracellular vesicles (sEVs), thereby facilitating intercellular communication and influencing major cancer hallmarks such as angiogenesis, evasion of the immune system, and metastatic dissemination. Furthermore, sEV-ncRNAs have shown promising potential as liquid biopsies with diagnostic and prognostic significance. In this review, we summarize the role of sEVs as carriers of ncRNAs and underlying molecular mechanisms in pancreatic cancer. Moreover, we review the potential of sEV-ncRNAs as biomarkers and highlight the suitability of sEVs as delivery vehicles for ncRNA-based cancer therapy.

中文翻译：

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胰腺癌中的小细胞外囊泡非编码 RNA：分子机制和临床意义

胰腺癌在常见肿瘤中预后最差，这归因于其侵袭性表型、晚期诊断、无法手术的阶段以及对全身治疗的抵抗力。非编码 RNA (ncRNA)，例如 microRNA、长链非编码 RNA 和环状 RNA，已被确定为基因表达的重要调节因子，并且它们的失调与多种疾病和最重要的癌症有关。在肿瘤微环境中，非编码 RNA 可以通过小细胞外囊泡 (sEVs) 分布在癌细胞、基质细胞和免疫细胞中，从而促进细胞间通讯并影响主要的癌症标志，如血管生成、免疫系统逃避和转移性传播。此外，sEV-ncRNAs 已显示出作为具有诊断和预后意义的液体活检的潜力。在这篇综述中，我们总结了 sEV 作为 ncRNA 载体的作用以及胰腺癌中的潜在分子机制。此外，我们回顾了 sEV-ncRNA 作为生物标志物的潜力，并强调了 sEV 作为基于 ncRNA 的癌症治疗的载体的适用性。