Biomarcadores en cáncer gástrico avanzado y metastásico, el papel predictivo y pronóstico de la vitamina D

Abstract

In this thesis, the relationship between prognosis in gastric cancer and biochemical, molecular and clinical markers was related. Observational, ambispective and multicentric trial was designed with two cohorts: localized and metastatic gastric cancer. In localized gastric cancer cohort, patients with severe deficiency of vitamin D presented poor prognosis. Patients with downregulated miR-125b, miR-181b-5p, miR181c-5p and miR-181d-5p in tumoral and normal tissue adjacent to tumor presented shorter time to relapse and worse survival. PALV score was stablished based on C-reactive protein, albumin, vitamin D and functional status. Patients with high score presented worse survival and shorter time to relapse compared to low and intermediate risk. In metastatic gastric cancer setting, basal neutrophil-to-lymphocyte ratio and change neutrophil-to-lymphocyte ratio were independent prognostic factors in overall survival. Furthermore, these measures combined were predictive factors of response in first line chemotherapy