Biomarcadores moleculares para la detección de cáncer gástrico

Abstract

El cáncer gástrico (CE) es la causa principal de muerte en el mundo, especialmente en Asia y América Latina. En Ecuador, representa el 2.3% de las muertes del país. La detección temprana es difícil, realizada mediante endoscopia invasiva de manera tardía. Existen biomarcadores en saliva y sangre analizados para mejorar el diagnóstico precoz sin invasión y economía. Esta revisión se enfoca en identificar los biomarcadores más prometedores para su uso clínico entre los biomarcadores prometedores como CSTB, TPI1, y DMBT1 en saliva, y uPAR en sangre, que podrían mejorar la detección y pronóstico del cáncer gástrico. Además, se destacan biomarcadores como CEA, CA 19-9, y ciertos microARN que también muestran potencial. Aunque estos biomarcadores ofrecen esperanza, se necesita más investigación y validación para su uso clínico. La detección temprana a través de biomarcadores no invasivos podría revolucionar el diagnóstico del CE, mejorando significativamente las tasas de supervivencia. Abstract Gastric cancer (GC) represents one of the main causes of mortality worldwide, due to the fact that it is usually diagnosed in advanced stages, which limits the possibilities of effective treatment and significantly reduces the survival rate. This situation raises the need for earlier and less invasive diagnostic tools to identify the disease in its early stages. In this context, the present research aimed to identify molecular biomarkers with potential for the early detection of GC, through a systematic literature review with a qualitative approach. For this purpose, high-impact scientific publications available in databases such as PubMed, Scopus, SciELO and Google Scholar were collected and analyzed, selecting relevant, updated (2012-2022) studies with proven scientific validity. The methodology included critical review of clinical studies, controlled trials and review articles addressing biomarkers in saliva and blood related to GC diagnosis, prognosis or monitoring. Markers such as CEA, CA 19-9, uPAR, microRNAs, proinflammatory cytokines and salivary proteins such as CSTB, TPI1 and DMBT1 were studied. The results were organized in a comparative table where parameters such as sensitivity, specificity, clinical applicability and validation in humans were evaluated. In addition, the biomarkers were classified by type (protein, genetic, inflammatory) and biological origin (saliva or blood), which made it possible to identify those with the greatest potential for noninvasive clinical implementation. In conclusion, this research showed that some molecular biomarkers offer important advantages for the early detection of gastric cancer, providing a solid scientific basis for future research and possible applications in clinical contexts.