Información del artículo
Resumen
El melanoma (MM) es la primera causa de muerte por cáncer cutáneo, pese a que sólo representa un 4% dentro del conjunto de las neoplasias cutáneas.
El mecanismo patogénico implicado en el desarrollo del melanoma no se conoce bien en la actualidad. Sin embargo, es indudable la existencia de una interacción de factores ambientales y genéticos.
El desarrollo de la biología molecular en el campo de la Medicina ha mostrado un crecimiento exponencial en los últimos años. En el área de la Dermatología su aplicación al estudio del MM ha supuesto importantes avances en cuanto al conocimiento de las principales vías moleculares implicadas en su desarrollo. Estos hallazgos no sólo permiten un mejor conocimiento en cuanto a la patogenia de la enfermedad, sino que además tienen una utilidad práctica. Por una parte, la caracterización molecular del MM puede ser de gran ayuda en el diagnóstico diferencial entre lesiones melanocíticas benignas y malignas, en las que los criterios histopatológicos resultan insuficientes, como ocurre en el caso del nevus de Spitz y del melanoma spitzoide. Por otro lado, el conocimiento de las vías moleculares alteradas en las diversas lesiones melanocíticas malignas establece nuevas dianas terapéuticas en el manejo de los melanomas con diseminación a distancia, en los que el tratamiento quimioterápico utilizado en la actualidad ha fracasado en su objetivo de alargar la esperanza de vida.
Actualmente el empleo de estas técnicas en el campo dermatológico tiene principalmente la limitación de la disponibilidad, ya que su uso en muchos casos se restringe a trabajos de investigación, de manera que no están accesibles en la mayoría de los hospitales. Sin embargo, este problema probablemente se solventará en el momento en el que se estandaricen los patrones moleculares que permitan establecer una caracterización pronóstica y terapéutica de esta importante entidad.
Palabras clave:
melanoma
cáncer cutáneo
biología molecular
pronóstico
tratamiento
fisiopatología
Abstract
Even though malignant melanoma accounts for 4% of all skin cancers, it is the type responsible for most deaths.
The pathogenesis of melanoma is currently not well understood, although an interaction of environmental and genetic factors doubtlessly plays a role.
Molecular biology in medicine has progressed increasingly rapidly in recent years. In dermatology, application of molecular biology techniques to the study of malignant melanoma has led to important advances in our knowledge of the main molecular pathways implicated in its development. These findings not only can improve our knowledge of the pathogenesis of the disease but may also have practical implications. Thus, molecular characterization of malignant melanoma may be of great help in differentiating between benign and malignant melanocytic lesions when histopathological features prove insufficient as is the case, for example, in Spitz nevus and spitzoid melanoma. In addition, knowledge of the abnormal molecular pathways in different malignant melanoma lesions can point to new therapeutic targets for treating patients with melanomas with distant metastases, in whom current chemotherapy has failed to extend life expectancy.
At present, lack of availability is the main barrier to use of these techniques in dermatology—they are often limited to research, so not generally available in most hospitals. This problem will, however, be overcome when the molecular patterns become standardized, allowing a prognostic and therapeutic characterization of this important disease.
Key words:
melanoma
skin cancer
molecular biology
prognosis
treatment
pathophysiology
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