The role of extracellular vesicles-associated proteins markers in prostate cancer: a review.

Prostate cancer (PCa) is in the top three most common cancers among the world's male population, and its incidence has been increasing over the years. However, the primary screening and diagnostic tools still rely on serum prostate-specific antigen (PSA) and digital rectal examination (DRE), both of which have been inconclusive. Raised serum PSA and abnormal DRE findings require an invasive prostate biopsy, which has inherent surgical risk. This review aims to provide a comprehensive understanding of the biological production and properties of extracellular vesicles (EVs), which are released by all cell types, including cancer cells, and carry proteins and other biomolecules from their parent cells. EVs are becoming increasingly popular as possible biomarker candidates to improve the accuracy of diagnosing many diseases. Growing data suggest that EVs are crucial for cellular communication and tumour progression via multiple signalling pathways, including epithelial-to-mesenchymal transition (EMT), migration, and invasion, making them suitable for tracking PCa growth and metastasis. Furthermore, choosing the appropriate EV isolation method is essential to ensure accurate diagnosis. More clinically relevant, this review also identifies potential EV protein biomarkers derived from urine, serum, and tissue samples from PCa patients.