Un análisis de sangre podría detectar los tipos de cáncer más comunes cuatro años que los métodos actuales
Científicos chinos y estadounidenses han descrito este método aún preliminar que podría aplicarse en cinco tipos comunes de tumores
Un equipo internacional de investigadores ha desarrollado un análisis de sangre no invasivo que puede detectar si una persona tiene uno de los cinco tipos comunes de cáncer, estómago, esófago, colorrectal, pulmón e hígado, cuatro años antes de que la afección pueda ser diagnosticada con los métodos actuales, según publican en la revista ‘Nature Communications’.
Llamada ‘PanSeer’, la prueba detectó cáncer en el 91% de las muestras de individuos que eran asintomáticos cuando se recogieron las muestras y solo fueron diagnosticados con cáncer de uno a cuatro años después. Además, la prueba detectó con precisión el cáncer en el 88% de las muestras de 113 pacientes que ya habían sido diagnosticados cuando se recogieron las muestras. La prueba también reconoció muestras libres de cáncer el 95% de las veces.
El estudio es único en el sentido de que los investigadores tuvieron acceso a muestras de sangre de pacientes asintomáticos y que aún no habían sido diagnosticados. Esto permitió al equipo desarrollar una prueba que puede encontrar marcadores de cáncer mucho antes que los métodos de diagnóstico convencionales. Las muestras fueron recogidas como parte de un estudio longitudinal de 10 años iniciado en 2007 por la Universidad Fudan, en China.
“El objetivo final sería realizar análisis de sangre como este de forma rutinaria durante los chequeos de salud anuales -señala Kun Zhang, uno de los autores correspondientes del artículo y profesor y presidente del Departamento de Bioingeniería de la Universidad de California en San Diego-. Pero el enfoque inmediato es evaluar a las personas con mayor riesgo, en función de los antecedentes familiares, la edad u otros factores de riesgo conocidos”.
La detección temprana es importante porque la supervivencia de los pacientes con cáncer aumenta significativamente cuando la enfermedad se identifica en etapas tempranas, ya que el tumor puede extirparse quirúrgicamente o tratarse con los medicamentos apropiados. Sin embargo, solo existe un número limitado de pruebas de detección temprana para algunos tipos de cáncer.
En el equipo participan investigadores de la Universidad de Fudan y de Singlera Genomics, una startup con sede en San Diego y Shanghái que está trabajando para comercializar las pruebas basadas en los avances realizados originalmente en el laboratorio de bioingeniería de Zhang en la Escuela de Ingeniería UC San Diego Jac
Los investigadores enfatizan que es poco probable que el ensayo ‘PanSeer’ prediga qué pacientes van a desarrollarán cáncer sino que identifica a los pacientes que ya tienen crecimientos cancerosos, pero que permanecen asintomáticos para los métodos de detección actuales. El equipo concluye que se necesitan más estudios longitudinales a gran escala para confirmar el potencial de la prueba para la detección temprana del cáncer en individuos pre-diagnósticos.
Las muestras de sangre se recogieron como parte del Estudio Longitudinal Taizhou, que ha recogido muestras de plasma de más de 120,000 personas entre 2007 y 2017. Cada individuo dio muestras de sangre durante un período de 10 años y se sometió a controles regulares con los médicos. En total, se han recolectado y archivado más de 1,6 millones de especímenes hasta la fecha.
Una vez que una persona fue diagnosticada con cáncer, los investigadores tuvieron acceso a muestras de sangre tomadas de uno a cuatro años antes de que estos pacientes comenzaran a mostrar síntomas.
El equipo pudo examinar muestras de individuos sanos y enfermos de la misma cohorte. Los autores realizaron un análisis en muestras de plasma obtenidas de 605 individuos asintomáticos, de los cuales 191 fueron diagnosticados posteriormente con cáncer. También perfilan muestras de plasma de 223 pacientes con cáncer adicionales diagnosticados, así como 200 muestras de tumor primario y tejido normal.
Zhang y su laboratorio han estado desarrollando durante más de una década métodos para detectar el cáncer basados en un proceso biológico llamado análisis de metilación del ADN. El método detecta una firma de ADN particular llamada metilación de CpG, que es la adición de grupos metilo a múltiples secuencias CG adyacentes en una molécula de ADN. Cada tejido en el cuerpo puede identificarse por su firma única de haplotipos de metilación. Hicieron un estudio de prueba de concepto en una etapa temprana que se publicó en un artículo de 2017 en ‘Nature Genetics’.
Zhang cofundó Singlera Genomics, que autorizó la tecnología que desarrolló en UC San Diego. En los últimos años, ha estado trabajando para mejorar y eventualmente comercializar las pruebas de detección temprana del cáncer, incluida la prueba ‘PanSeer’. Ahora el asesor científico de la compañía.
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