Global trends and future perspectives on exosomes in colorectal cancer: a comprehensive bibliometric analysis (2003-2024)

Background Colorectal cancer (CRC) is one of the most frequent malignant tumors in the world. Its pathogenesis is complex and prone to metastasis and relapse, so novel diagnostic biomarkers and therapeutic strategies are urgently needed. As nanoscale vesicles secreted by cells, exosomes carry bioactive molecules, including nucleic acids, proteins, and lipids, and play a key role in regulating the tumor microenvironment (TME), forming the pre-metastatic niche (PMN) and contributing to drug resistance in CRC. Through bibliometrics, this study reviewed research progress, cooperation networks, and frontiers of exosomes in the field of CRC to fill the gap of systematic analysis and provide a theoretical basis for future research. Methods Based on the Web of Science Core Collection (WOSCC) database, the relevant literature on exosomes in the field of CRC from 2003 to 2024 was searched. Tools such as CiteSpace, VOSviewer, RStudio, GraphPad, and SciExplorer are used to visually analyze publishing trends, national contribution, institutional cooperation, author influence, journal distribution, co-citation network, and keyword co-occurrence to predict future research hotspots. Results This study included 1705 articles from 76 countries, involving 9113 authors and 2240 institutions, and published in 513 journals. The analysis showed that the research on exosomes in CRC showed a continuous upward trend, especially in recent years, indicating that this field has received more and more attention and in-depth research. China leads the world in terms of research output (> 50%), but the number of citations per article is relatively low, while the United States stands out regarding citation impact and academic centrality. China's domestic academic cooperation is relatively active, but international cooperation must be strengthened. Cancers is the most widely published journal in the field. Simpson R.J. tops the list of authors with 16 papers, and Thery C. is the most frequently cited author. In addition to "colorectal cancer" and "extracellular vesicles," "metastasis," "biomarker," and "progression" are also popular keywords. It reflects that the research mainly focuses on the role of exosomes in the occurrence, development, diagnosis, prognosis, and treatment of CRC. Emerging research trends are gradually shifting from basic biological mechanisms to clinical applications and technological innovations, emphasizing the potential value of exosomes in the early diagnosis of CRC, therapeutic monitoring, and individualized therapy. Conclusion Through bibliometric analysis, this study reviewed the current research status and development trend of exosomes in CRC. Future studies should focus on strengthening international cooperation to promote the effective transformation of basic research into clinical application to achieve breakthroughs in CRC precision medicine.