{"id":23021,"date":"2023-03-01T18:26:20","date_gmt":"2023-03-01T17:26:20","guid":{"rendered":"https:\/\/idibell.cat\/?p=23021"},"modified":"2023-03-02T10:39:33","modified_gmt":"2023-03-02T09:39:33","slug":"noves-evidencies-per-a-la-correcta-deteccio-dels-cancers-dorofaringe-causats-pel-virus-del-papilloma-huma","status":"publish","type":"post","link":"https:\/\/idibell.cat\/2023\/03\/noves-evidencies-per-a-la-correcta-deteccio-dels-cancers-dorofaringe-causats-pel-virus-del-papilloma-huma\/","title":{"rendered":"Noves evid\u00e8ncies per a la correcta detecci\u00f3 dels c\u00e0ncers d&#8217;orofaringe causats pel virus del papil\u00b7loma hum\u00e0"},"content":{"rendered":"<p>Els c\u00e0ncers d&#8217;orofaringe causats pel virus del papil\u00b7loma hum\u00e0 (VPH) es caracteritzen per <strong>respondre millor al tractament i tenir una millor taxa de superviv\u00e8ncia<\/strong> que els no causats pel virus. La detecci\u00f3 de la prote\u00efna p16 \u00e9s la prova m\u00e9s extensament utilitzada, i la que recomanen algunes guies cl\u00edniques per a determinar la causalitat del VPH en el c\u00e0ncer d&#8217;orofaringe.<\/p>\n<p>Ara un treball coliderat pel grup d&#8217;Infeccions i C\u00e0ncer de l&#8217;Institut d&#8217;Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL) i l&#8217;Institut Catal\u00e0 d&#8217;Oncologia (ICO), conjuntament amb la Universitat de Birmingham, i publicat a la revista <a href=\"https:\/\/www.thelancet.com\/journals\/lanonc\/article\/PIIS1470-2045(23)00013-X\/fulltext\"><em>The Lancet Oncology<\/em><\/a>, ha demostrat que no tots els c\u00e0ncers d&#8217;orofaringe positius per p16 s\u00f3n causats pel virus del VPH. En el nostre \u00e0mbit <strong>fins a un 20% dels c\u00e0ncers positius per p16 no es detecta DNA o RNA del virus<\/strong>.<\/p>\n<p>Amb aquests resultats els investigadors recomanen realitzar la doble prova de p16 i DNA o RNA viral per determinar si el c\u00e0ncer d&#8217;orofaringe \u00e9s causat per VPH, ja que del contrari es pot classificar malament una proporci\u00f3 significativa de pacients, el que pot arribar a comportar errors en el seu maneig cl\u00ednic.<\/p>\n<p>&#8220;<em>Quan el VPH infecta les c\u00e8l\u00b7lules de l&#8217;epiteli de l&#8217;orofaringe aquestes sobreexpresen la prote\u00efna p16, per tant, es tracta d&#8217;una prova indirecta de la infecci\u00f3 viral amb activitat oncog\u00e8nica. Els casos que no detectem ni DNA ni RNA del virus ens indiquen que el m\u00e9s probable \u00e9s que hi hagi hagut altres factors, independents del virus, que han indu\u00eft la sobreexpressi\u00f3 de p16 i que no es tracta d&#8217;un c\u00e0ncer VPH relacionat<\/em>&#8220;, afirma la <strong>Dra. Laia Alemany<\/strong>, cap del grup de recerca d&#8217;Infeccions i C\u00e0ncer de l&#8217;IDIBELL i de l&#8217;ICO i \u00faltima autora del treball.<\/p>\n<p>&nbsp;<\/p>\n<h4><span style=\"color: #993300;\"><strong>Implicacions cl\u00edniques d&#8217;una mala classificaci\u00f3 dels c\u00e0ncers d&#8217;orofaringe<\/strong><\/span><\/h4>\n<p>Pel fet que els c\u00e0ncers d&#8217;orofaringe relacionats amb el VPH tenen un millor pron\u00f2stic, diversos assajos cl\u00ednics han valorat, o estan valorant, <strong>possibles estrat\u00e8gies de desintensificaci\u00f3 del tractament<\/strong> en aquests pacients.<\/p>\n<p>Si nom\u00e9s es t\u00e9 en compte el p16 com a biomarcador diagn\u00f2stic de la causalitat del VPH. Primerament, es poden classificar err\u00f2niament fins a un 20% dels pacients amb c\u00e0ncer d&#8217;orofaringe i el m\u00e9s important, es pot desintensificar el tractament a pacients que no tenen c\u00e0ncers d&#8217;orofaringe relacionats amb el VPH. &#8220;<em>\u00c9s molt important fer la doble comprovaci\u00f3 de p16 i DNA\/RNA viral a tots els pacients que s&#8217;incloguin en els assajos cl\u00ednics de desintensificaci\u00f3 per tal d&#8217;obtenir resultats fiables<\/em>&#8220;, asseguren els investigadors.<\/p>\n<p>&nbsp;<\/p>\n<h4><span style=\"color: #993300;\"><strong>Difer\u00e8ncies geogr\u00e0fiques en la causalitat del c\u00e0ncer d&#8217;orofaringe<\/strong><\/span><\/h4>\n<p>Per a la realitzaci\u00f3 d&#8217;aquest estudi, els autors han col\u00b7laborat amb investigadors d&#8217;Europa i el Canad\u00e0 per incloure <strong>13 cohorts amb un total de gaireb\u00e9 8000 pacients amb c\u00e0ncer d&#8217;orofaringe<\/strong> procedents del Regne Unit, Canad\u00e0, Dinamarca, Su\u00e8cia, Fran\u00e7a, Alemanya, Pa\u00efsos Baixos, Su\u00efssa i Espanya.<\/p>\n<p>El qu\u00e8 s&#8217;ha vist \u00e9s que <strong>el percentatge de pacients positius per p16 en els que no es detecta DNA\/RNA viral varia significativament entre regions<\/strong>. En els pa\u00efsos on el percentatge de c\u00e0ncer d&#8217;orofaringe causat pel VPH \u00e9s m\u00e9s elevat, existeix una menor discordan\u00e7a entre la p16 i el DNA o RNA viral.<\/p>\n<p>La <strong>Dra. Alemany<\/strong> ho resumeix de la seg\u00fcent manera: &#8220;<em>En aquells pa\u00efsos que la majoria de c\u00e0ncers d&#8217;orofaringe s\u00f3n originats pel virus, tindran menys percentatge de discordants i, per tant, la recomanaci\u00f3 de doble prova no ser\u00e0 necess\u00e0ria. No ser\u00e0 aix\u00ed en els pa\u00efsos on hi hagi major proporci\u00f3 de c\u00e0ncers causada per altres factors com tabac.<\/em>&#8221;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><em>L\u2019Institut d&#8217;Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL) \u00e9s un centre de recerca en biomedicina creat l\u2019any 2004. Est\u00e0 participat per l&#8217;Hospital Universitari de Bellvitge i l\u2019Hospital de Viladecans de l&#8217;Institut Catal\u00e0 de la Salut, l&#8217;Institut Catal\u00e0 d&#8217;Oncologia, la Universitat de Barcelona i l\u2019Ajuntament de l\u2019Hospitalet de Llobregat.<\/em><\/p>\n<p><em>L\u2019IDIBELL \u00e9s membre del Campus d&#8217;Excel\u00b7l\u00e8ncia Internacional de la Universitat de Barcelona HUBc i forma part de la instituci\u00f3 CERCA de la Generalitat de Catalunya. L&#8217;any 2009 es va convertir en un dels cinc primers centres d\u2019investigaci\u00f3 espanyols acreditats com a institut d\u2019investigaci\u00f3 sanit\u00e0ria per l\u2019Instituto de Salud Carlos III. A m\u00e9s, forma part del programa \u201cHR Excellence in Research\u201d de la Uni\u00f3 Europea i \u00e9s membre de EATRIS i REGIC. Des de l\u2019any 2018, l\u2019IDIBELL \u00e9s un Centro Acreditado de la Fundaci\u00f3n Cient\u00edfica AECC (FCAECC).<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Fins ara per a establir si un c\u00e0ncer d&#8217;orofaringe estava relacionat amb el virus del papil\u00b7loma hum\u00e0 es recomanava fer-ho a trav\u00e9s de la detecci\u00f3 de la prote\u00efna p16. Ara un equip de l&#8217;IDIBELL ha publicat a The Lancet Oncology un estudi on es demostra que no tots els c\u00e0ncers d\u2019orofaringe positius per p16 s\u00f3n causats pel virus.<\/p>\n","protected":false},"author":8,"featured_media":23025,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[332,337,446,454],"tags":[],"publishpress_future_action":{"enabled":false,"date":"2024-05-12 16:09:04","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"_links":{"self":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/23021"}],"collection":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/comments?post=23021"}],"version-history":[{"count":3,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/23021\/revisions"}],"predecessor-version":[{"id":23026,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/23021\/revisions\/23026"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media\/23025"}],"wp:attachment":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media?parent=23021"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/categories?post=23021"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/tags?post=23021"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}