02.06.01. Investigación y comunicación científica

Varices estomales: una causa infrecuente de sangrado en pacientes con hipertensión portal

2026-04-28T11:32:22Z

Varices estomales: una causa infrecuente de sangrado en pacientes con hipertensión portal Trasancos-Escura, Cristina; Carrillo-George, Carlos; Muñoz-Bertrán, Eduardo-Domingo; Bebia-Conesa, Paloma Las varices estomales son una causa infrecuente de sangrado en los pacientes con hepatopatía e hipertensión portal, que puede tener graves consecuencias, por lo que es necesario un diagnóstico y tratamiento precoces. Existen diversas opciones terapéuticas, pero la más recomendada es el descenso de la presión portal mediante la realización de un shunt porto-sistémico intrahepático transyugular (TIPS). Presentamos el caso de un paciente con cirrosis y episodios de sangrado recidivante secundario a varices ectópicas a nivel de la ureteroileostomía, que no respondió a tratamiento conservador precisando realización de TIPS.

Concordancia diagnóstica entre la cápsula endoscópica y enteroscopia de doble balón en la hemorragia digestiva media en un centro de referencia

2026-04-28T08:30:02Z

Concordancia diagnóstica entre la cápsula endoscópica y enteroscopia de doble balón en la hemorragia digestiva media en un centro de referencia Pérez-Cuadrado-Robles, Enrique; Esteban-Delgado, Pilar; Martínez-Andrés, Blanca; Zamora-Nava, Luis-Eduardo; Rodrigo-Agudo, José-Luis; Chacón-Martínez, Silvia; Torrella-Cortés, Emilio; Shanabo, Jamal; López-Higueras, Antonio; Muñoz-Bertrán, Eduardo-Domingo; Hallal, Hacibe; Latorre, Rafael; López-Albors, Octavio; Soria, Federico; Bebia-Conesa, Paloma; Pérez-Cuadrado-Martínez, Enrique Introducción y objetivo: la capsula endoscópica y la enteroscopia de doble balón son técnicas de reconocido valor en el estudio de la hemorragia digestiva media, habiendo numerosos factores que pueden afectar a su rendimiento diagnóstico. El objetivo del presente estudio es el de caracterizar y definir los niveles de concordancia entre ambas focalizando en el tipo de lesión, en una gran cohorte de pacientes de un centro de referencia. Material y método: entre los años 2004-2014 se administraron 1.209 cápsulas en 1.078 pacientes y se realizaron 381 enteroscopias en 361 pacientes con hemorragia digestiva media. Resultados: en 332 pacientes (edad media: 65,22 ± 15,41, 183 hombres) se realizaron ambos procedimientos. Ambas técnicas tuvieron un rendimiento diagnóstico similar (70,5% vs. 69,6%, p = 0,9). El rendimiento diagnóstico global de la enteroscopia fue superior en pacientes con una cápsula previa positiva (79,3% vs. 27,9%, p < 0,001). La concordancia diagnóstica entre los resultados por cápsula y enteroscopia para cada lesión fue muy buena para pólipos (0,89 [95% IC: 0,78-0,99]), buena en las lesiones vasculares (0,66 [95% IC: 0,55-0,77]), tumores (0,66 [95% IC: 0,55-0,76]) y moderada para úlceras (0.56 [95% IC: 0,46-0,67]). Los divertículos (0,39 [95% IC: 0,29-0,5] tuvieron una concordancia razonable. Los resultados entre ambos procedimientos difirieron en 73 pacientes (22%). Conclusiones: el presente estudio evidencia que aunque el rendimiento de la cápsula endoscópica y la enteroscopia de doble balón de forma global sean similares, hay numerosos factores que pueden modificar estos valores, siendo el principal el tipo de lesión.

Implication of Hepsin from Primary Tumor in the Prognosis of Colorectal Cancer Patients

2026-04-20T11:24:55Z

Implication of Hepsin from Primary Tumor in the Prognosis of Colorectal Cancer Patients Zaragoza-Huesca, David; Nieto-Olivares, Andres; Garcia-Molina, Francisco; Ricote, Guillermo; Montenegro, Sofia; Sánchez-Canovas, Manuel; Garrido-Rodríguez, Pedro; Penas-Martínez, Julia; Vicente, Vicente; Martínez, Francisco; Lozano, Maria-Luisa; Carmona-B Hepsin is a type II transmembrane serine protease whose deregulation promotes tumor invasion by proteolysis of the pericellular components. In colorectal cancer, the implication of hepsin is unknown. Consequently, we aimed to study the correlations between hepsin expression and different clinical-histopathological variables in 169 patients with localized colorectal cancer and 118 with metastases. Tissue microarrays were produced from samples at diagnosis of primary tumors and stained with an anti-hepsin antibody. Hepsin expression was correlated with clinical-histopathological variables by using the chi-square and Kruskal?Wallis tests, Kaplan?Meier and Aalen?Johansen estimators, and Cox and Fine and Gray multivariate models. In localized cancer patients, high-intensity hepsin staining was associated with reduced 5-year disease-free survival (p-value = 0.16). Medium and high intensity of hepsin expression versus low expression was associated with an increased risk of metastatic relapse (hazard ratio 2.83, p-value = 0.035 and hazard ratio 3.30, p-value = 0.012, respectively), being a better prognostic factor than classic histological variables. Additionally, in patients with localized tumor, 5-year thrombosis cumulative incidence increased with the increment of hepsin expression (p-value = 0.038). Medium and high intensities of hepsin with respect to low intensity were associated with an increase in thrombotic risk (hazard ratio 7.71, p-value = 0.043 and hazard ratio 9.02, p-value = 0.028, respectively). This relationship was independent of previous tumor relapse (p-value = 0.036). Among metastatic patients, low hepsin expression was associated with a low degree of tumor differentiation (p-value < 0.001) and with major metastatic dissemination (p-value = 0.023). Hepsin is a potential thrombotic and metastatic biomarker in patients with localized colorectal cancer. In metastatic patients, hepsin behaves in a paradoxical way with respect to differentiation and invasion processes

Comprehensive Landscape of Diagnostic, Prognostic and Predictive Biomarkers in Colorectal Cancer: From Genomics to Multi-Omics Integration in Precision Medicine.

2026-04-20T09:52:43Z

Comprehensive Landscape of Diagnostic, Prognostic and Predictive Biomarkers in Colorectal Cancer: From Genomics to Multi-Omics Integration in Precision Medicine. Agüera-Sánchez, Alfonso; Peña-Ros, Emilio; Martínez-Martínez, Irene; García-Molina, Francisco Colorectal cancer (CRC) remains one of the leading causes of cancer-related morbidity and mortality worldwide. Despite advances in screening and therapeutic strategies, early detection and individualized treatment remain major challenges. In recent years, an expanding repertoire of biomarkers has emerged, spanning genomic, transcriptomic, proteomic, and metabolomic signatures. Epigenetic features, such as DNA methylation panels, as well as non-coding RNAs and the gut microbiome, hold potential not only for improving early diagnosis but also for refining prognosis and predicting therapeutic responses within the framework of precision oncology. This narrative review provides an updated, integrative overview of CRC diagnostic, prognostic, and predictive biomarkers. We distinguish established markers already in clinical practice, such as RAS and BRAF mutations, HER2 amplification, microsatellite instability/mismatch repair deficiency (MSI/dMMR), and widely investigated molecular alterations including TP53 mutations and immune-checkpoint-related markers, from novel biomarkers with growing translational potential. We also discuss the implementation challenges of these biomarkers in clinical practice, including issues related to validation, standardization, and cost-effectiveness, as well as the multi-modal approach for the development of composite diagnostic panels.