Hacia una medicina de precisión: biomarcadores moleculares para la detección temprana y el pronóstico en cáncer de cuello uterino

Toward precision medicine: molecular biomarkers for early detection and prognosis in cervical cancer

Publicado 2026-02-17

Resumen gráfico Hacia una medicina de precisión: biomarcadores moleculares para la detección temprana y el pronóstico en cáncer de cuello uterino
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Combita-Rojas AL. Hacia una medicina de precisión: biomarcadores moleculares para la detección temprana y el pronóstico en cáncer de cuello uterino. Rev. colomb. hematol. oncol. [Internet]. 2026 Feb. 17 [cited 2026 Feb. 17];13(1-Supl):399-424. https://doi.org/10.51643/22562915.852

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Vol. 13 Núm. 1-Supl (2026): Biología molecular tumoral: de la básica a la clínica
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Combita-Rojas AL. Hacia una medicina de precisión: biomarcadores moleculares para la detección temprana y el pronóstico en cáncer de cuello uterino. Rev. colomb. hematol. oncol. [Internet]. 2026 Feb. 17 [cited 2026 Feb. 17];13(1-Supl):399-424. https://doi.org/10.51643/22562915.852
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Alba Lucia Combita
Instituto Nacional de Cancerología image/svg+xml
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https://orcid.org/0000-0001-6295-7316
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Alba Lucia Combita,

Grupo de Investigación en Biología del Cáncer, Instituto Nacional de Cancerología (INC), Bogotá, Colombia. Grupo de Investigación Traslacional en Oncología, Instituto Nacional de Cancerología (INC), Bogotá, Colombia. Departamento de Microbiología, Departamento de Patología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá

Introducción: el cáncer de cuello uterino (CCU) sigue siendo un desafío de salud pública global, especialmente en países de ingresos bajos y medianos, con baja cobertura de vacunación contra el virus del papiloma humano (VPH) y programas de cribado limitados. Aunque la citología y la detección de ADN de VPH han reducido la mortalidad, sus limitaciones en sensibilidad y especificidad generan sobrediagnóstico y procedimientos innecesarios. En este contexto, los biomarcadores moleculares han surgido como herramientas prometedoras para mejorar la detección temprana, el cribado y la estratificación pronóstica del CCU.

Métodos: se realizó una revisión narrativa de la literatura basada en estudios clínicos y traslacionales que evalúan biomarcadores inmunohistoquímicos, epigenéticos y transcriptómicos asociados con la progresión del CCU.

Resultados: entre los biomarcadores inmunohistoquímicos, p16^INK4a^, Ki67, MCM2 y TOP2A demostraron mejorar la precisión diagnóstica y reducir derivaciones innecesarias. En el ámbito epigenético, la metilación del ADN viral (región L1) y de genes del huésped, como PAX1 y SOX1 se asociaron con lesiones de alto grado. Asimismo, los oncomiRNAs como miR-21 y miR-155 y supresores como miR-126 y miR-143 se relacionaron con la progresión tumoral y el pronóstico, y han mostrado ser útiles en biopsias líquidas, lo que refuerza su potencial como marcadores no invasivos. Los avances en epigenómica y transcriptómica han permitido identificar paneles multibiomarcadores con sensibilidad y especificidad superiores al 80%.

Conclusión: los biomarcadores moleculares representan herramientas prometedoras para un cribado de precisión en CCU. No obstante, la heterogeneidad metodológica exige estudios multicéntricos y de validación prospectiva antes de su implementación clínica.

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