Levels of glycoprotein-associated carbohydrates (neutral hexoses, hexosamine, sialic acid and fucose) were determined in the serum of patients with either local, regional or metastatic cancer, patients clinically cured of cancer, and controls (smokers and nonsmokers). Total protein-bound carbohydrates were compared with levels of 17 normal serum glycoproteins, carcinoembryonic antigen (CEA), and with lymphocyte reactivity to phytohemagglutin (PHA). Tumor burden was directly related to protein-bound carbohydrate levels in patient groups. Levels of bound carbohydrates reflect the sum of all the changes in serum glycoproteins, but primarily changes in the acute-phase proteins (alpha 1-acid glycoprotein, alpha 1-antitrypsin, haptoglobin, ceruloplasmin) found in the alpha-globulin fraction of serum. Increases in protein-bound carbohydrates in tumor-bearers were not related to increases in CEA. Increased levels of the acute-phase proteins occurred in individuals with depressed in vitro lymphocyte reactivity to PHA. A significant positive correlation was found between lymphocyte reactivity and level of alpha 2HS-glycoprotein. The results suggest that serum protein-bound carbohydrates or glycoproteins may be of adjunctive value is assessing tumor burden and immune reactivity in cancer patients.
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