The role and potential mechanisms of exosomes in the progression of hepatocellular carcinoma

Abstract Exosomes (EXOs), as pivotal mediators of intercellular communication, play a crucial role in the progression of hepatocellular carcinoma (HCC). This review explores the formation, secretion, and biological functions of tumor-derived and non-tumor-derived exosomes, emphasizing their involvement in key oncogenic processes such as immune suppression, metabolic reprogramming, proliferation, invasion, metastasis, angiogenesis, and drug resistance. The roles of exosomes from immune cells, fibroblasts, mesenchymal stem cells, and herbal sources in shaping the tumor microenvironment are also highlighted. Furthermore, the potential of exosomes as biomarkers for early diagnosis, prognosis assessment, and therapeutic targets is discussed. Despite their promising applications, challenges such as exosome heterogeneity, standardization of isolation techniques, and limited clinical validation remain significant barriers. Future research should prioritize elucidating the functional implications of exosome-mediated signaling pathways, developing reproducible methodologies, and conducting large-scale clinical trials. These efforts will deepen our understanding of HCC biology, facilitate the integration of exosome-based tools into clinical practice, and pave the way for innovative diagnostic and therapeutic strategies, ultimately improving patient outcomes in this challenging malignancy.