La mejor evidencia junto a la mejor organización: el reto de la coordinación profesional en atención oncológica. Ignacio A. Jornada Técnica: Atención Multidisciplinar en Cáncer como modelo de calidad asistencial (Madrid: Ministerio de Sanidad y Política Social, 2010)

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10. Cáncer de mama: clasificación molecular
(Perou et al, Nature 2000)
NRC, 2007

11. Información patológica dispersa
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14. Estudio patológico convencional CCR
Carcinoma colorrectal - Determinación estadio tumoral
- Infiltración (T)
- Afectación ganglionar (N)
- Marcadores pronósticos
- Invasión linfovascular
Vías oncogénicas CCR - Afectación márgenes quirúrgicos
Vía supresora (85%) Vía mutadora (15%) Papel del patólogo para identificar tumores
Alteración vía reparadora (IMS)
desarrollados por la vía mutadora
- Características clínico patológicas
- Estudio inmunohistoquímico de las proteínas reparadoras
Esporádico Sd Lynch
80% 20% (MLH1, MSH2, MSH6, PMS2): concordancia con IMS 99%
Metilación MLH1 Mutación germinaL
MLH1 MSH2 MSH6 PMS2
- Si pérdida de MLH1:
- Estudio de mutación BRAF (para detectar
casos esporádicos): stripassay (IZASA). No
requiere secuenciación
- Estudio de metilación de MLH1 (para
Mejor pronóstico
Peor respuesta a 5-FU detectar casos esporádicos): kit comercial
Identificar Sd Lynch (MLPA)
- Si pérdida MSH2/MSH6 o aislada de MSH6 o PMS2:
remitir a la UCG: probable Lynch

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16. ¿Por qué es necesario almacenar muestras con fines diagnósticos?
2008 1988
39 años 19 años
CD30 ALK
Linfoma anaplásico ALK
ALK CD30

17. Demanda creciente de muestras biológicas
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ARN
Investigación
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Consejo genético

18. BIOBANCOS. NODO DE TUMORES SÓLIDOS
ADN Linfocitos
-80º C linfocitos Inmortalizados
ADN ADN ADN
ARN ARN
Proteínas Proteínas
Cultivos

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21. ¡Muchas gracias!
aranda_ign@gva.es