Caracterización molecular de los tumores de páncreas y vías biliares
DOI:
https://doi.org/10.22529/me.2023.8(2)03Palabras clave:
cáncer de páncreas, colangiocarcinoma, mutaciones moleculares, factores pronósticosResumen
INTRODUCCIÓN: Los tumores de páncreas y vías biliares en general se diagnostican en una etapa avanzada, cuando las opciones curativas son escasas, lo cual se traduce a altas tasas de mortalidad. La resección completa es la única cura, pero sólo un pequeño porcentaje de pacientes presentan enfermedad en estadio temprano al diagnóstico. Por otro lado, entre los pacientes que se someten a cirugía curativa, tasas de recurrencia son extremadamente altas. En el momento actual no se dispone de un tratamiento sistémico claramente efectivo más allá de la primera línea y esto hace que nuevos estudios de investigación relacionados a la biología molecular que pueda definir nuevas líneas de tratamiento dirigido sea unanecesidad de urgencia en este contexto.OBJETIVO: Determinar la frecuencia de las diferentes alteraciones moleculares en tumores de vía biliar y páncreas y estudiar si existe relación entre la mutación hallada y la sobrevida de los pacientes. Evaluar el factor pronóstico de las variables de laboratorio al diagnóstico.MATERIAL Y MÉTODOS: Estudio retrospectivo y descriptivo, en el que se incluyeron 110 pacientes con diagnóstico de tumores de vías biliares o pancreáticos, evaluados por el equipo de la unidad de tumores digestivos del Hospital 12 de octubre entre febrero 2019 hasta el mes de julio del 2020.RESULTADOS: Se incluyeron 64 pacientes con diagnóstico de tumor de páncreas y 46 con tumores de vías biliares, la edad media fue de 61 años, el 43% de los pacientes se diagnosticó en estadio IV de la enfermedad, la sobrevida para los pacientes con tumores de páncreas en el periodo metastásico fue de 20 meses, 25 meses para los pacientes con tumores biliares. P53, K- ras, CDKN2A y SMAD fueron las mutaciones más frecuentemente encontradas en tumores de páncreas, ARID1A, FGFR e IDH en colangiocarcinoma intrahepático, P53 k-ras y CDKN2A en tumores extrahepáticos. Al investigar acerca de factores pronósticos, la hemoglobina y albúmina alterada al diagnóstico fueron parámetros con resultados estadísticamente significativos en relación con la sobrevida.CONCLUSIONES: Los avances recientes han aclarado las características genéticas y moleculares de tumores biliopancreáticos y ofrecen el potencial para el diagnóstico de base molecular de los mismos. Sin embargo, la aplicabilidad clínica de la mayoría de los marcadores existentes es limitada debido a una falta de sensibilidad y especificidad adecuadas; se requieren estudios adicionales para validar y confirmar la utilidad clínica de algunos marcadores prometedores. Los valores de hemoglobina y albumina aldiagnóstico podrían ser utilizados como factores pronósticos en pacientes con tumores pancreáticos.Descargas
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