We investigated the diagnostic and prognostic potential of serum N-glycan profiling for castrationresistant prostate cancer (CRPC). We retrospectively investigated serum N-glycan structural analysis by glycoblotting for 287 patients with benign prostatic hyperplasia (BPH), 289 patients with newly diagnosed prostate cancer (PC), 57 patients with PC treated with androgen-deprivation therapy without disease progression (PC-ADT), and 60 patients with CRPC. N-Glycan profiling was compared between the non-CRPC (BPH, newly diagnosed PC and PC-ADT) and CRPC patients. We obtained the quantitative score for CRPC (CRPC N-glycan score) by discriminant analysis based on the combination of 9 N-glycans that were significantly associated with CRPC. The median CRPC N-glycan score was found to be significantly greater in CRPC patients than in non-CRPC patients. The CRPC N-glycan score could classify CRPC patients with sensitivity, specificity, and area under the curve of 87%, 69%, and 0.88, respectively. the cRpc N-glycan score >1.7 points was significantly associated with poor prognosis in patients with CRPC. The glycoprotein analysis showed that not immunoglobulins but α-1-acid glycoprotein (AGP) were a potential candidate for the carrier protein of N-glycans. The overexpression of specific N-glycans may be associated with their castration-resistant status and be a potential biomarker for CRPC. Prostate cancer(PC) has been increasing worldwide and major cancer in Japan in recent years 1. Although prostate-specific antigen (PSA) is a useful biomarker for PC detection 2-4 , the utility of PSA for castration-resistant PC (CRPC) is insufficient 5-9. Several new prognostic markers, including the clinicopathological status and liquid biopsy (such as circulating tumor cell and cell-free DNA) have been investigated in CRPC 10-13. Of those, several biomarkers for CRPC using serum glycans have been reported to date 14-16. More than half of the proteins have glycans and glycans play crucial roles in molecular interactions and signal transduction 17. As glycosylation for proteins and lipids was tightly controlled by glycosyltransferases, malfunction of the glycan system is related to several diseases and cancers 18-25. Although cancer-associated glycan alterations represent potential cancer biomarkers, it has not been applied clinically because of the complicated protocols and the analytical methods involved. A new approach that combines chemoselective N-glycan enrichment (glycoblotting methods) and quantitative N-glycan mass spectrometry improved N-glycan analysis 26. Our previous studies suggested that a quantitative N-glycan analysis is a promising approach for biomarker screening in several cancers 14,21,27-30. Among these studies, a few evaluated the potential diagnostic value of serum N-glycomics (tri-and tetra-antennary N-glycans) in patients with CRPC 14,21,30. In the present study, we evaluated the diagnostic and prognostic potential of serum N-glycan profiling for CRPC using a combination of serum N-glycans. Results Table 1 summar...