Análisis de biopsias líquidas para el diagnóstico del cáncer: revisión sistemática / Analysis of liquid biopsies for cancer diagnosis: systematic review

La incidencia del cáncer ha aumentado en los últimos años, especialmente en mayores de 65 años, suponiendo un problema sanitario de primer orden. Muchos tumores presentan mal pronóstico debido a que se diagnostican en etapas muy avanzadas, por ello muestra especial importancia incorporar en la práctica clínica la biopsia líquida como método para la detección tumoral en etapas muy tempranas. Se ha realizado una revisión sistemática con el objetivo principal de analizar la bibliografía disponible sobre la utilización de la biopsia líquida en el diagnóstico precoz del cáncer, y como objetivo secundario, conocer los tipos tumorales que pueden ser diagnosticados precozmente mediante la biopsia líquida y los biomarcadores disponibles. Los resultados indican una falta de concordancia en los biomarcadores detectados y tecnologías aplicadas, lo que destaca la necesidad de realizar estudios multicéntricos en grandes cohortes y establecer protocolos de actuación, para aumentar la validez analítica y poder disponer de un screening para cada tipo de tumor, lo cual sería un adelanto muy importante, pues podría mejorar en gran medida el manejo de los pacientes con cáncer

The incidence of cancer has increased in recent years, especially in those over 65 years of age, posing a major health problem. Many tumours have a poor prognosis because they are diagnosed at very advanced stages. It is therefore especially important to incorporate liquid biopsy into clinical practice as a method for detecting tumours at very early stages. A systematic review was conducted, with the main objective of analysing the available literature on the use of liquid biopsy in the early diagnosis of cancer, and as a secondary objective, to determine the types of tumours that can be diagnosed early by liquid biopsy and the available biomarkers. The results indicate a lack of agreement with the biomarkers detected and the technologies applied. This highlights the need for multicentre studies to look at large cohorts and to establish protocols of action, as well as to increase analytical validity and the possibility of using a screening test for each type of tumour. This could be a very important step forward, as it could improve the management of cancer patients to a great extent

[Analysis of liquid biopsies for cancer diagnosis: Systematic review]. / Análisis de biopsias líquidas para el diagnóstico del cáncer: revisión sistemática.

The incidence of cancer has increased in recent years, especially in those over 65 years of age, posing a major health problem. Many tumours have a poor prognosis because they are diagnosed at very advanced stages. It is therefore especially important to incorporate liquid biopsy into clinical practice as a method for detecting tumours at very early stages. A systematic review was conducted, with the main objective of analysing the available literature on the use of liquid biopsy in the early diagnosis of cancer, and as a secondary objective, to determine the types of tumours that can be diagnosed early by liquid biopsy and the available biomarkers. The results indicate a lack of agreement with the biomarkers detected and the technologies applied. This highlights the need for multicentre studies to look at large cohorts and to establish protocols of action, as well as to increase analytical validity and the possibility of using a screening test for each type of tumour. This could be a very important step forward, as it could improve the management of cancer patients to a great extent.

[Neurophysiology and ageing. Definition and pathophysiological foundations of cognitive impairment]. / Neurofisiología y envejecimiento. Concepto y bases fisiopatológicas del deterioro cognitivo.

Brain ageing is produced by various morphological, biochemical, metabolic and circulatory changes, which are reflected in functional changes, whose impact depends on the presence or absence of cognitive impairment. Because of brain plasticity, together with redundancy of the distinct cerebral circuits, age- related deterioration of the brain at various levels does not always translate into loss of brain function. However, when the damage exceeds certain thresholds, there is age-related cognitive impairment, which increases the risk of developing various neurodegenerative diseases such as Alzheimer disease. Genetics, together with lifestyle, diet, and environmental factors, etc, can trigger the development of these diseases, which provoke cognitive impairment. This article discusses the most important age-related changes in the brain, as well as the pathophysiological foundations of cognitive impairment.

Neurofisiología y envejecimiento. Concepto y bases fisiopatológicas del deterioro cognitivo / Neurophysiology and ageing. Definition and pathophysiological foundations of cognitive impairment

El envejecimiento cerebral se produce por diversos cambios morfológicos, bioquímicos, metabólicos y circulatorios, que se traducen en cambios funcionales, de cuyo alcance depende el desarrollo o no de deterioro cognitivo. La plasticidad cerebral, junto con la redundancia de los distintos circuitos cerebrales, hace que, aun habiendo deterioro del cerebro a distintos niveles con el envejecimiento, estos no se traduzcan en pérdida de las capacidades funcionales del mismo. Sin embargo, cuando el daño supera unos determinados límites aparece el deterioro cognitivo asociado a la edad, que aumenta el riesgo de desarrollo de diversas enfermedades neurodegenerativas, como la enfermedad de Alzheimer. La genética, junto con el estilo de vida, la alimentación, factores ambientales, etc. pueden precipitar la aparición de estas enfermedades que cursan con deterioro cognitivo. En este capítulo se comentan los cambios cerebrales más importantes asociados al envejecimiento, así como las bases fisiopatológicas del deterioro cognitivo (AU)

Brain ageing is produced by various morphological, biochemical, metabolic and circulatory changes, which are reflected in functional changes, whose impact depends on the presence or absence of cognitive impairment. Because of brain plasticity, together with redundancy of the distinct cerebral circuits, agerelated deterioration of the brain at various levels does not always translate into loss of brain function. However, when the damage exceeds certain thresholds, there is age-related cognitive impairment, which increases the risk of developing various neurodegenerative diseases such as Alzheimer disease. Genetics, together with lifestyle, diet, and environmental factors, etc, can trigger the development of these diseases, which provoke cognitive impairment. This article discusses the most important age-related changes in the brain, as well as the pathophysiological foundations of cognitive impairment (AU)

El estrés oxidativo como predictor de longevidad; estudio de casos y controles / Oxidative stress and longevity; a case-control study

Introducción. La longevidad humana es un fenómeno complejo en el que influyen factores genéticos y ambientales. El estrés oxidativo (EO) puede jugar un papel importante en este proceso. El envejecimiento exitoso podría relacionarse con la habilidad del organismo para hacer frente al EO. Nuestro objetivo es comparar los niveles en plasma de malondialdehído (MDA) y proteínas oxidadas (PO) entre sujetos mayores de 97 años y con edad entre 70 y 80 años, para comprender mejor los efectos del estrés oxidativo en la longevidad humana. Material y métodos. Estudio de casos y controles de base poblacional. Se consideraron casos todas aquellas personas nacidas y residentes en la comarca de la Ribera (Valencia), con edad superior a 97 años y que aceptaron participar en el mismo. Los controles son sujetos de la misma base poblacional, elegidos al azar, y con edad entre 70 y 80 años. Se realiza un análisis descriptivo de variables sociodemográficas, clínicas y funcionales; se calcula la razón de odds (OR) de ser centenario en función del cuartil de los niveles de PO y MDA; y la significación estadística de la tendencia mediante el test Mantel-Haenszel. Resultados. Fueron incluidos 28 casos y 31 controles. La situación funcional, así como el porcentaje de individuos robustos, fue menor en el grupo de casos que en los controles. Los niveles de MDA fueron menores en los casos (1,44 ± 0,45 vs. 1,84 ± 0,59, p = 0,005), al igual que los niveles de PO (64,29 ± 15,73 vs. 76,52 ± 13,44, p = 0,002). Al comparar a los sujetos con niveles de MDA y PO en el cuartil inferior respecto al superior, la OR de ser centenario es de 3,8 para el MDA y de 5,7 para las PO, con una p = 0,029 y p = 0,044, respectivamente, en la significación de la tendencia. Conclusiones. En los sujetos de nuestro estudio los niveles plasmáticos de MDA y PO son menores en centenarios que en ancianos más jóvenes, y se observa que a menor grado de EO mayor es la probabilidad de ser centenario (AU)

Introduction. Human longevity is a complex issue influenced by genetic and environmental factors. Oxidative stress (OE) could play an important role in this process. Succesful aging could be related with the organism ability facing OE. In the present study we compared malondialdehyde (MDA) and oxidized proteins (OP) plasma levels, in elderly people older than 97 years and 70-80 years old, to better understand the effects of OE on human longevity. Material and methods. Population-based case control study. We considered as cases patients who were born and live on la Ribera county in Valencia (Spain) older than 97 years old and who accepted to participate in the study. Controls were from the same poblational base, chosen randomly, and 70-80 years old. We made a descriptive analysis of sociodemographic, clinic and functional variables; an odds ratio (OR) estimation of being centenarian by OP and MDA quartiles; and a tendency analysis by Mantel-Haenszel test. Results. Twenty eight cases and 31 controls were included. Functional state and robust percentage were worse in cases. MDA (1,44 ± 0,45 vs 1,84 ± 0,59, p = 0,005), and OP (64,29 ± 15,73 vs. 76,52 ± 13,44, p = 0,002) levels, were significantly lower in cases. The OR of being centenarian in lower/higher quartile were 3,8 for MDA and 5,7 for OP, with a Mantel-Haenszel signification of 0,029 and 0,044 respectively. Conclusions. In our study OE level were lower in centenarians than in younger elderly, and the lower the OE grade, the higher were the likelihood of being centenarian (AU)

[Oxidative stress and longevity; a case-control study]. / El estrés oxidativo como predictor de longevidad; estudio de casos y controles.

INTRODUCTION: Human longevity is a complex issue influenced by genetic and environmental factors. Oxidative stress (OE) could play an important role in this process. Succesful aging could be related with the organism ability facing OE. In the present study we compared malondialdehyde (MDA) and oxidized proteins (OP) plasma levels, in elderly people older than 97 years and 70-80 years old, to better understand the effects of OE on human longevity. MATERIAL AND METHODS: Population-based case control study. We considered as cases patients who were born and live on la Ribera county in Valencia (Spain) older than 97 years old and who accepted to participate in the study. Controls were from the same poblational base, chosen randomly, and 70-80 years old. We made a descriptive analysis of sociodemographic, clinic and functional variables; an odds ratio (OR) estimation of being centenarian by OP and MDA quartiles; and a tendency analysis by Mantel-Haenszel test. RESULTS: Twenty eight cases and 31 controls were included. Functional state and robust percentage were worse in cases. MDA (1,44±0,45 vs 1,84±0,59, p=0,005), and OP (64,29±15,73 vs. 76,52±13,44, p=0,002) levels, were significantly lower in cases. The OR of being centenarian in lower/higher quartile were 3,8 for MDA and 5,7 for OP, with a Mantel-Haenszel signification of 0,029 and 0,044 respectively. CONCLUSIONS: In our study OE level were lower in centenarians than in younger elderly, and the lower the OE grade, the higher were the likelihood of being centenarian.