Background/Objectives: Cervical cancer remains a significant global health burden, underscoring the imperative for refined diagnostic and prognostic methodologies. This study aimed to evaluate the potential of extracellular vesicles (EVs) as non-invasive biomarkers for cervical cancer, focusing on diagnosis and prognosis.Methods:We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines to assess the diagnostic and prognostic accuracy of EV-based biomarkers. We searched PubMed, EMBASE, and Web of Science for relevant studies. Twelve articles met the inclusion criteria: eight related to diagnostic accuracy, three to prognosis, and one to both outcomes. Six studies met the criteria for meta-analysis. We used a random-effects model to synthesise diagnostic data, while prognostic data were synthesised narratively.Results:The meta-analysis yielded a pooled area under the receiver operating characteristic curve (AUC) of 0.87 (95% CI 0.80–0.92) for EVs in the diagnosis of cervical cancer, indicating high accuracy. The evaluated diagnostic biomarkers were primarily non-coding RNAs. For prognosis, data heterogeneity precluded quantitative synthesis; however, individual studies identified diverse EV-associated molecules correlated with recurrence and survival. GRADE assessment indicated a high risk of bias and heterogeneity across studies.Conclusions:Extracellular vesicles demonstrate robust promise as diagnostic biomarkers for cervical cancer; however, their prognostic utility remains inconclusive due to methodological and clinical heterogeneity. Future research must prioritise the standardisation of isolation protocols and the execution of large-scale, prospective studies to validate EV biomarkers for clinical application.Systematic Review Registration:PROSPERO, identifier: CRD420251014411.
背景/目的：宫颈癌仍是全球重大健康负担，凸显了优化诊断与预后评估方法的迫切性。本研究旨在评估细胞外囊泡作为宫颈癌无创生物标志物在诊断与预后方面的应用潜力。 方法：我们依据PRISMA指南开展系统综述与荟萃分析，评估基于细胞外囊泡生物标志物的诊断与预后效能。检索PubMed、EMBASE及Web of Science数据库，最终纳入12篇文献：8篇涉及诊断准确性，3篇涉及预后评估，1篇同时涵盖两方面。其中6项研究符合荟萃分析条件。诊断数据采用随机效应模型进行整合，预后数据则进行叙述性综合。 结果：荟萃分析显示细胞外囊泡诊断宫颈癌的综合受试者工作特征曲线下面积为0.87（95% CI 0.80–0.92），提示其具有高诊断准确性。所评估的诊断生物标志物主要为非编码RNA。在预后方面，数据异质性阻碍了定量整合，但多项独立研究发现了与复发和生存相关的多种细胞外囊泡相关分子。GRADE评估显示各研究存在较高的偏倚风险与异质性。 结论：细胞外囊泡作为宫颈癌诊断生物标志物展现出显著潜力，但其预后价值因方法学与临床异质性尚未明确。未来研究需重点推进分离流程标准化，并开展大规模前瞻性研究以验证细胞外囊泡生物标志物的临床应用价值。 系统综述注册号：PROSPERO，标识码：CRD420251014411。
肿瘤(癌症)患者之家