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Li N, Jiao Y, Liu ZC. Extracellular vesicles in gastrointestinal diseases: A narrative minireview of translational readiness. World J Gastrointest Oncol 2026; 18(12): 125325 [DOI: 10.4251/wjgo.125325]
World J Gastrointest Oncol. Dec 15, 2026; 18(12): 125325 Published online Dec 15, 2026. doi: 10.4251/wjgo.125325
Extracellular vesicles in gastrointestinal diseases: A narrative minireview of translational readiness
Na Li, Yan Jiao, Zhi-Cheng Liu
Na Li, Department of Anesthesia Recovery Room, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Yan Jiao, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Zhi-Cheng Liu, Department of Gastrointestinal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Co-corresponding authors: Yan Jiao and Zhi-Cheng Liu.
Author contributions: Li N contributed to drafting the manuscript and preparing the initial figure design; Jiao Y and Liu ZC contributed to conceiving the review and critically revising the manuscript, and they contributed equally to this manuscript and are co-corresponding authors; Jiao Y contributed to supervising the study and editing the manuscript; Liu ZC contributed to supervising the project and finalizing the manuscript for submission. All authors reviewed the literature, approved the final version of the manuscript, and agreed to be accountable for all aspects of the work.
AI contribution statement: ChatGPT (OpenAI; GPT-5, accessed September 7, 2026) was used for language polishing. It was not used to generate or analyze original research data, generate the scientific content of Figure 1, or determine scientific conclusions. Figure 1 was designed and assembled by the authors. All AI-assisted content was critically reviewed, verified, and approved by the authors, who take full responsibility for the accuracy, originality, and integrity of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Zhi-Cheng Liu, PhD, Department of Gastrointestinal Surgery, General Surgery Center, The First Hospital of Jilin University, Xinmin Street, Changchun 130021, Jilin Province, China. foolishboylzc@jlu.edu.cn
Received: July 7, 2026 Revised: August 27, 2026 Accepted: September 24, 2026 Published online: December 15, 2026 Processing time: 129 Days and 9.4 Hours
Abstract
Extracellular vesicles (EVs) mediate communication among epithelial, immune, stromal, microbial, and tumor compartments in gastrointestinal diseases. This narrative minireview integrates inflammatory bowel disease and major gastrointestinal malignancies (colorectal, gastric, pancreatic, and liver cancers) using a five-stage translational-readiness framework: Discovery, analytical validation, clinical validation, regulatory development, and implementation. We distinguish discovery-stage and preclinical findings from clinically validated applications. EV cargo and engineered EV platforms show potential for biomarker panels, liquid biopsy, drug delivery, and regenerative medicine, but no broad EV assay or therapeutic platform is established for routine precision gastroenterology. Key barriers include pre-analytical variability, isolation-dependent results, incomplete cargo attribution, cohort heterogeneity, limited independent validation, and manufacturing and safety requirements. Progress will require standardized workflows, disease-specific comparators, prospective multicenter validation, and evidence-calibrated integration of EV data with conventional biomarkers and multi-omics.
Core Tip: Extracellular vesicles (EVs) connect mucosal inflammation, host-microbial communication, tumor progression, and therapeutic resistance. Their near-term clinical value is most plausible in standardized, disease-specific multi-analyte panels rather than isolated markers, while engineered therapeutic EVs remain predominantly preclinical. The distinguishing contribution of this minireview is a disease-by-disease, operational matrix that links intended-use populations and current-care comparators to evidence level and the next validation gate. This narrative minireview separates human evidence from animal and in vitro findings, compares EV assays with current clinical standards, and proposes a staged path from discovery and analytical validation to clinical validation, regulatory development, and implementation.
