2010, Número 09-10
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Medicina & Laboratorio 2010; 16 (09-10)
Utilidad clínica de los marcadores tumorales
Campuzano MG
Idioma: Español
Referencias bibliográficas: 379
Paginas: 411-445
Archivo PDF: 743.12 Kb.
RESUMEN
Los marcadores tumorales, también denominados marcadores biológicos o biomarcadores, se definen como moléculas, sustancias o procesos que se alteran cualitativa o cuantitativamente como resultado de una condición precancerosa o un cáncer, detectables mediante una prueba de laboratorio en sangre, en líquidos orgánicos o en tejidos. La naturaleza de los marcadores tumorales es muy variable: va desde ácido nucleico, ADN o ARN, una proteína o un péptido, hasta procesos complejos como un anticuerpo, la apoptosis, la amilogénesis y la proliferación. Desde el punto de vista de su origen, los marcadores tumorales se producen por el tumor mismo, como la gonadotropina coriónica en el coriocarcinoma, o como respuesta a la lesión tumoral en el tejido circundante, como el antígeno carcinoembrionario en el cáncer de mama. No hay un marcador tumoral ideal, definido como aquel con una sensibilidad y especificidad del 100%. Los marcadores tumorales pueden ser utilizados para el cribado en población con riesgo de presentar un cáncer para su detección precoz con enfermedad confinada y potencialmente curable, como parte del diagnóstico, en el diagnóstico diferencial, como prueba de valor pronóstico y predictivo, como herramienta para evaluar el tratamiento administrado, y para la detección de las recaídas cuando éstas se presentan y el paciente tiene una nueva oportunidad de tratamiento, antes de que las manifestaciones clínicas reaparezcan. En este módulo se analizan los principales marcadores tumorales disponibles en el medio, como el antígeno carcinoembrionario, la alfafetoproteína, el antígeno específico de próstata, el CA 15-3, el CA 125, el CA 19-9, el Cyfra 21-1, la gonadotropina coriónica, la calcitonina, la ferritina, la beta 2 microglobulina, entre otros marcadores. Además, se hará referencia a marcadores subrogados de cáncer, como la presencia de la infección por
Helicobacter pylori y el virus del papiloma humano.
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