Serum Glycoproteins as Prognosticator in Oral Cancer Patients-A Follow up Study

Abstract

AIM : To estimate the glycoprotein levels (Protein bound hexose, Fucose and Total sialic acid) in pre-treatment and post treatment phases with a follow up of one year, and to know the prognostic significance of glycoproteins in oral cancer patients. METHODS : 56 patients with different stages of oral cancer in accordance to AJCC TNM staging (American Joint Committee of cancer) were included along with 20 healthy individuals for the control group which were selected at random. All the patients were subjected to biochemical analysis of protein bound hexose, fucose and total sialic acid levels before treatment (S1), immediately after treatment (S2), 6 months after treatment (S3) and one year after treatment (S4) and compared with the levels of these serum glycoproteins amongst control groups. 31 patients were available for the 6 months and one year follow up. Statistical analysis methods employed were student's ‘t’ test and paired ‘t’ test. Further to this, 6 months to one year clinical follow up was also carried out. RESULTS : Significant elevation (p<0.001) was observed in levels of the serum glycoproteins in all the oral cancer patients when compared to the control group. It was seen that the increased levels correlated well with the clinical stages of malignancies. Post treatment levels were significantly decreased in all the serum glycoproteins except in total sialic acid where it increased in stage III & IV in S3 and S4 phases with the transient reductions occurring in S2 phase, in the absence of visible local disease (p<0.001). It was further noted that the levels in two recurrent cases were also decreased soon after the treatment when compared to the pre-treatment values but again started increasing in S3 and S4. CONCLUSION : The tumor markers are useful for monitoring the malignant disease. The protein bound hexose, fucose and total sialic acid level indicate tumor burden and total sialic acid levels proved to be better prognostic markers.