Publication Name	World Journal of Gastroenterology
Manuscript ID	117869
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Opinion Review
Article Title	Extracellular vesicles as biomarkers for metabolic dysfunction-associated steatotic liver disease staging: Methodological innovations and future perspectives
Manuscript Source	Unsolicited Manuscript
All Author List	Yu-Tong Wu, Yi-Lin Shi, Xiao-Ying Xie, Jing Ma, Yan-Qi Dang and Dan Hu
Funding Agency and Grant Number	Funding Agency Grant Number Science and Technology Development Fund of Shanghai Pudong New Area PKJ2024-Y19 Investigator-Initiated Trial Program of Shanghai Pudong New Area Health Commission 2025-PWDL-03 National Pilot Zone for Inheritance, Innovation and Development of Traditional Chinese Medicine in Pudong New Area PDZY-2026-0318 Science and Technology Development Project of Shanghai University of Traditional Chinese Medicine 25KFL82
Corresponding Author	Yan-Qi Dang, Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases, Shanghai University of Traditional Chinese Medicine, Fenglin Road Sub-district, Shanghai 200032, China. dangyanqi9022@126.com
Key Words	Metabolic dysfunction-associated steatotic liver disease; Extracellular vesicles; Non-invasive biomarkers; Machine learning; Explainable artificial intelligence
Core Tip	Trifylli et al have pioneered the integration of nanoparticle tracking analysis with the CatBoost algorithm and SHapley Additive exPlanations interpretability analysis, thereby uncovering non-linear relationships between extracellular vesicles (EV) characteristics and steatosis severity. The study establishes that EV mean size and concentration can function as independent predictors to distinguish S0 stage, while combination with clinical features significantly improved S3 stage identification accuracy. This provides novel insights and methodologies for non-invasive diagnosis and risk stratification of metabolic dysfunction-associated steatotic liver disease. However, limitations in sample size and unclear mechanistic understanding may hinder further clinical translation, representing urgent issues requiring resolution.
Citation	Wu YT, Shi YL, Xie XY, Ma J, Dang YQ, Hu D. Extracellular vesicles as biomarkers for metabolic dysfunction-associated steatotic liver disease staging: Methodological innovations and future perspectives. World J Gastroenterol 2026; In press

Received	2025-12-18 02:23
Peer-Review Started	2025-12-18 02:23
First Decision by Editorial Office Director	2026-01-27 09:27
Return for Revision	2026-01-27 09:27
Revised	2026-02-07 06:43
Publication Fee Transferred
Second Decision by Editor	2026-05-25 02:37
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-05-25 07:29
Articles in Press	2026-05-25 07:29
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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