Pharmaceutical care of patients with hepatocellular carcinoma: could gags be useful as a diagnostic and prognostic tumor marker?

ABSTRACT

Despite the very high incidence of hepatocellular carcinoma [HCC] in Egypt, surgery is considered as the only curative treatment option. However, most patients are diagnosed at advanced stages thereby surgery will be of little value. The aim of the current study was to provide a pharmaceutical care for patients with HCC who were treated with the investigational drug mistletoe as well as to assess whether glycosaminoglycans [GAGs] could be useful as an effective screening tumor marker for early diagnosis and to investigate the significance of total GAGs serum concentrations in patients with HCC. Blood samples were collected from three groups the first group [n=50] with HCC, the second with cirrhosis [n=15] and the third was a control [n=15]. Liver and kidney functions laboratory tests and total GAGs concentrations were measured. Only 23% of the patients achieved objective responses to the investigational drug but monitoring of the supportive treatments as well as drug side effects and toxicities were strongly recommended. Patients with HCC showed a significant increase in serum GAGs as compared with the control group [p<0.01]. However, there were no significant differences between cirrhotic group with HCC group or with control group. A significant positive correlation between serum level of GAGs and tumor size [r=0.39, p<0.005] was observed, however there are no correlations between serum concentration of GAGs with other patients or with tumor characteristics. No significant relationship was found between serum level of GAGs and overall survival. We could conclude that pharmaceutical care is very important in patients with HCC to improve their quality of life and serum level of GAGs may have a role in HCC, and their serum level may be related to a high tumor burden