In patients with paired circulation and tumor specimens, we found that circulating exosomal miR-221-3p level was positively associated with tumor miR-221-3p levels (r = 0.721, P < 0.001) and lymphangiogenesis (r = 0.512, P < 0.001) but was negatively correlated with VASH1 expression (r = − 0.588, P < 0.001) (Fig. 6c). The gene discussed is VASH1; the disease is neoplasm.