Resumen
El cáncer colorrectal (CCR) es uno de los más frecuentes y letales en México y el mundo. Es de resaltar que, a nivel global, la incidencia del CCR aumenta a razón del 2% anual en pacientes menores de 50 años. Su detección temprana, basada principalmente en la colonoscopia a partir de los 45 años, es una de las armas más importantes en la clínica para disminuir su mortalidad. Cuando la neoplasia está presente, la piedra angular en el tratamiento es la cirugía, sin embargo, factores pronósticos señalados en los reportes de patología y la investigación biomédica del microambiente tumoral pueden ofrecer nuevos parámetros que sirvan como biomarcadores de pronóstico y predicción. En este sentido, señalar la presencia o ausencia de células de la respuesta inmune comienza a dar indicios de su relevancia pronóstica. Si bien este campo es aún controversial, nuestras evidencias recientes indican que la presencia de neutrófilos con un fenotipo antitumoral, particularmente en el margen invasivo de tumores del colon, podría ser un indicativo de buen pronóstico. Esta información emergente sugiere que la descripción de las características de las células de la respuesta inmune, en particular la de los neutrófilos, podría contribuir a evaluar la evolución del CCR y a identificar a los pacientes con mayor riesgo de recurrencias. En este artículo, discutimos algunos puntos relevantes que deben ser abordados al momento de la interpretación de la información relacionada con los neutrófilos en el contexto del CCR.
Abstract
Colorectal cancer (CRC) is one of the most frequent and lethal cancers in Mexico and the world. It is noteworthy that globally, the incidence of CRC is increasing at a rate of 2% per year in patients younger than 50 years of age. Its early detection, primarily based on colonoscopy screening starting at 45 years of age, is an essential weapon to reduce its mortality. When CRC is detected, the treatment is surgical; however, the pathology reports and biomedical research on the tumor microenvironment may offer new parameters that could serve as prognostic biomarkers. In this respect, the presence or absence of neutrophils associated with neoplastic tissues may indicate their prognostic relevance for the disease. Although this field is still controversial, our recently published evidence suggests that the presence of neutrophils with an anti-tumoral phenotype, particularly at the invasive margin of the colon tumors, could indicate a favorable prognosis. This emerging information suggests that the characterization of immune cells, particularly neutrophils, could contribute to assessing the evolution of CRC and identifying patients at increased risk of recurrences. In this article, we discuss relevant points that should be addressed when interpreting neutrophil-related data in the context of CRC.
World Health Organzation. Global Cancer Observatory. Lyon, France: WHO; 2020. Disponible en: https://gco.iarc.fr/
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