结肠直肠癌通常起源于大肠内非恶性息肉的形成，随着时间的推移，发展为结肠直肠癌。如果在疾病的早期阶段检测到良性肿瘤的增长，可以进行检查。医生通常建议普通人和高风险人群进行结肠镜检查进行结肠直肠癌筛查。升高的癌胚抗原（CEA）是结肠直肠癌的一种广泛使用的生物标志物。在各种临床研究中，p53、BRAF、APC和PIK3CA等基因的遗传和表观遗传改变与结肠直肠癌有关。通常，组织活检是最常用于诊断结肠直肠癌的方法，但是通过这种技术无法访问整个肿瘤的多样性。此外，这种高度侵入性的技术不适用于反复测试。最近，从结肠直肠癌细胞分泌出来的脂质双层包裹的囊泡，也称为细胞外囊泡（EVs），正逐渐成为结肠癌检测的一种诊断工具。使用细胞外囊泡进行结肠癌诊断的主要优点是（i）可以以非侵入性的方式从体液中分离出EVs，以及（ii）EV携带的载体（主要是RNA）揭示了结肠直肠癌的各个方面。EV-RNAs也与肿瘤侵袭和影响免疫系统进一步扩散肿瘤有关。然而，由于缺乏标准化的EV检测策略，诊断适用性有限。在这里，我们回顾了关于结肠直肠癌对EV-RNAs的病理生物学依赖的最新文献。此外，我们介绍了识别和表征EV-RNAs的优点，以探究细胞外囊泡携带RNA的差异表达与结肠直肠癌之间的联系。还讨论了这种方法如何潜在地转化成结肠直肠癌诊断的便捷点。© 2022 The Authors. Published by American Chemical Society.

Colorectal cancer typically begins from a nonmalignant polyp formation in the large intestine that, over time, develops into colorectal cancer. The growth of benign polyps can be checked if detected in the early stages of the disease. Doctors usually recommend colonoscopy to average and high-risk individuals for colorectal cancer screening. Elevated carcinoembryonic antigen (CEA) is a broadly used biomarker for colorectal cancer. The genetic and epigenetic alteration of genes such as p53, BRAF, APC, and PIK3CA is also correlated with colorectal cancer in various clinical studies. In general, tissue biopsy is most frequently used for colorectal cancer diagnosis, but the whole tumor heterogeneity cannot be accessed by this technique. Furthermore, such a highly invasive technique is not suitable for repeated testing. Recently, extracellular vesicles (EVs), lipid bilayer enclosed sacs secreted from colorectal cancer cells, are emerging as a diagnostic tool for colon cancer detection. The major advantages of using EVs for colon cancer diagnosis are (i) EVs can be isolated in a noninvasive manner from the body fluid and (ii) EV incorporated cargoes (mostly RNAs) reveal various aspects of colorectal cancer. EV-RNAs are also implicated in tumor invasion and influence the immune system for the further spread of tumors. However, due to the lack of standardized EV detection strategies, diagnostic applicability is limited. Herein, we review the recent literature on the pathobiological dependence of colorectal cancer on EV-RNAs. Further, we present the advantages of identification and characterization of EV-RNAs to explore the connection between differential expression of extracellular vesicle incorporated RNAs and colorectal cancer. How this approach may potentially translate into point of care colorectal cancer diagnostics is also discussed.© 2022 The Authors. Published by American Chemical Society.