Extracellular Glycosaminoglycans in Management of Primary Hepatocellular Carcinoma Rather than Alpha Fetoprotein

Abstract

Objectives: Extracellular matrix (ECM) is an essential player at various stages of carcinogenesis. Current study aims to evaluate diagnostic value of components of ECM, released to the serum, i.e. total glycosaminoglycans (TGAGs), total sialic acid (TSA) and free glucosamine (FGA) in primary HCC patients solely or confounded by other conditions (i.e. diabetes mellitus (DM), hepatitis C virus (HCV) or bilharziasis (B). Design and Methods: Our study was conducted upon 40 HCC patients: 32 (80%) males, 8 (20%) females, among these samples, patients with ascites, single/or multiple HCC lesions, as shown in demographic Table. Results: Liver and renal indices were significantly disturbed in HCC patients. Significant elevations of AFP, TGAGS and FGA, non-significant increases in TSA in HCC patients compared to normal control. These parameters except AFP showed significant persistent higher levels during cancer progression. AFP showed irrelevant changes to the stages of HCC lesion. HCC patients with HCV, DM or B showed significantly higher levels of AFP than with HCC solely. Both TGAGs and FGA showed the highest diagnostic accuracy over AFP, but TSA showed the lowest value. Conclusion: TGAGs and FGA may be regarded as cost-effective and more accurate diagnostic tools during primary HCC progression, whether solely, or commixed by other diseases.