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El cáncer de vejiga generalmente se evalúa mediante el examen del tejido extraído de la vejiga, ya sea mediante cirugía o mediante biopsia; sin embargo, los oligoelementos en la orina, conocidos como biomarcadores, también pueden proporcionar informaciones sobre el diagnóstico. El desafío surge cuando los dos métodos no están de acuerdo: la muestra de tejido es positiva para cáncer, pero el biomarcador es negativo o al revés.La citología urinaria aún representa un complemento esencial en el seguimiento del TVNMI.Pacientes con citología positiva durante su seguimiento deben ser evaluados cuidadosamente con una cistoscopia y biopsias aleatorias múltiples de la vejiga.En el futuro, un alto valor predictivo negativo de los biomarcadores podría usarse en pacientes que no requieran un seguimiento mediante la cistoscopia. Respecto a esto, los biomarcadores urinarios requieren un desarrollo adicional, para poder aceptar su uso sin requerir asociarlos a otra prueba diagnóstica habitual.
El cáncer de vejiga generalmente se evalúa mediante el examen del tejido extraído de la vejiga, ya sea mediante cirugía o mediante biopsia; sin embargo, los oligoelementos en la orina, conocidos como biomarcadores, también pueden proporcionar informaciones sobre el diagnóstico. El desafío surge cuando los dos métodos no están de acuerdo: la muestra de tejido es positiva para cáncer, pero el biomarcador es negativo o al revés.La citología urinaria aún representa un complemento esencial en el seguimiento del TVNMI.Pacientes con citología positiva durante su seguimiento deben ser evaluados cuidadosamente con una cistoscopia y biopsias aleatorias múltiples de la vejiga.En el futuro, un alto valor predictivo negativo de los biomarcadores podría usarse en pacientes que no requieran un seguimiento mediante la cistoscopia. Respecto a esto, los biomarcadores urinarios requieren un desarrollo adicional, para poder aceptar su uso sin requerir asociarlos a otra prueba diagnóstica habitual.
Human epidermal growth factor receptor 2 (HER2) belongs to the ErbB family, a group of four transmembrane glycoproteins with tyrosine kinase activity, all structurally related to epidermal growth factor receptor (EGFR). These tyrosine kinases are involved in the transmission of cellular signals controlling normal cell growth and differentiation. If this transmission goes awry, it can lead to dysregulated growth of the cell. HER2 specifically can be implicated in the pathogenesis of at least eight malignancies. HER2 positivity quickly became a well-characterized indicator of aggressiveness and poor prognosis, with high rates of disease progression and mortality. After realizing the implication of HER2, it first became investigated as a target for treatment in breast cancer, and later expanded to areas of research in other cancer types. To this day, the most therapeutic advancements of anti-HER2 therapy have been in breast cancer; however, there have been strong advancements made in the incorporation of anti-HER2 therapy in other cancer types as well. This comprehensive review dissects HER2 to its core, incorporating the most up to date information. The topics touched upon are discussed in detail and up to 200 published sources from the most highly recognized journals have been integrated. The importance of knowing about HER2 is exemplified by the groundbreaking advancements that have been made, and the change in treatment plans it has brought to the oncological world in the last twenty years. Since its groundbreaking discovery there have been significant breakthroughs in knowledge regarding the actual receptor, the receptors biology, its mechanism of action, and advancements in tests to detect HER2 and significant strides on how to best incorporate targeted treatment. Due to the success of this field thus far, the review concludes by discussing the future of novel anti-HER2 therapy currently in development that everyone should be aware of.
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