Metabolómica no Carcinoma da Bexiga: Estado Atual e Perspetivas Futuras
DOI:
https://doi.org/10.24915/aup.35.1-2.64Palavras-chave:
Biomarcadores Tumorais, Metaboloma, Metabolómica, Neoplasias da Bexiga UrináriaResumo
Introdução: O carcinoma da bexiga é o nono tumor mais comum em todo o mundo e o tumor mais comum do sistema urinário com incidência crescente. Apesar da alta frequência e mortalidade associada a este tumor, pouco evoluiu recentemente quanto ao diagnóstico e tratamento desta patologia. De facto, a cistoscopia e a citologia urinária ainda são os métodos preconizados para a detecção do carcinoma da bexiga. O desenvolvimento de técnicas diagnósticas menos invasivas e mais confiáveis é fundamental. Nesse sentido, a metabolómica surgiu recentemente como uma técnica promissora para o diagnóstico e orientação de doenças oncológicas.
Aquisição de Evidências: Fizemos uma pesquisa exaustiva dos estudos sobre metabolómica e carcinoma da bexiga publicados antes de Outubro de 2017, recorrendo à base bibliográfica da PubMed, Medline e Web of Science. Realizamos uma revisão da literatura, tentando esclarecer o que já é conhecido sobre a aplicação da metabolómica no carcinoma da bexiga e quais as perspectivas futuras.
Síntese de Evidências: A aquisição espectral é feita usando predominantemente duas plataformas analíticas: ressonância magnética e espectrometria de massa. No que diz respeito ao carcinoma da bexiga, vários metabolitos foram associados à presença de tumor, levando à criação de um perfil metabolómico capaz de identificar os pacientes com carcinoma da bexiga. Além do diagnóstico, a metabolómica também foi estudada para estratificar os casos de carcinoma da bexiga de acordo com sua agressividade. Neste sentido, existem estudos que utilizaram a análise metabolómica para distinguir entre tumores vesicais de baixo e alto grau. Uma investigação mostrou que os níveis de carnitina foram maiores nos doentes com carcinoma da bexiga músculo-invasivo do que naqueles com tumores não invasivos, o que sugere que estes achados podem estar correlacionados com a agressividade tumoral.
Conclusão: Os biomarcadores detectados pela metabolómica fornecem uma visão da biologia tumoral e usados de forma adequada poderão levar ao desenvolvimento de novas estratégias para o diagnóstico e tratamento do carcinoma da bexiga.
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