Fig. 4: The potential of EV-ncRNAs as biomarkers and therapeutic agents in TC.

In diagnosis, EV-derived miRNAs, such as miR-146b-5p, miR-21a-5p, and Let-7 family members, show differential expression in patients with PTC versus benign conditions, offering promising biomarkers for early detection and differentiation. Additionally, circRNAs like hsa_circ_0082002 are elevated in PTC, correlating with lymph node metastasis and serving as potential diagnostic markers. In treatment, EV-ncRNAs contribute to overcoming therapeutic challenges. For instance, exosomal miR-1296-5p is implicated in radioiodine refractory PTC by targeting the Na+/I− symporter. EVs also serve as efficient delivery vehicles for therapeutic agents, such as siRNA and chemotherapeutic drugs, enhancing targeting and reducing side effects. Engineered exosomes carrying miRNAs like miR-152 and miR-30c-5p demonstrate potential in inhibiting tumor growth and metastasis, highlighting their role as innovative therapeutic tools in TC management. Therefore, EV-derived ncRNAs hold significant diagnostic and therapeutic potential in TC, serving as biomarkers for early detection and enhancing treatment efficacy through targeted delivery.