[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-331552-105":59,"doc-detail-331552-en":135},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":128,"head_meta":130,"extra_data":132,"updated_unix":134},105,"en","the-diagnostic-utility-of-glycosaminoglycans-gags-in-the-early-detection-of-cancer-a-systematic-review","The diagnostic utility of glycosaminoglycans (GAGs) in the early detection of cancer - a systematic review","","Glycosaminoglycans (GAGs) are extracellular matrix polysaccharides whose dysregulation influences key cancer hallmarks, motivating their use as early diagnostic biomarkers. This systematic review evaluates the diagnostic accuracy of GAGs, including heparan sulfate, chondroitin sulfate, and hyaluronic acid, for early cancer detection. Four databases were searched in English over 15 years, applying a two-stage screening and critical appraisal using CASP and Newcastle-Ottawa Scale.",{"@graph":69,"@context":127},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-diagnostic-utility-of-glycosaminoglycans-gags-in-the-early-detection-of-cancer-a-systematic-review/331552/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-diagnostic-utility-of-glycosaminoglycans-gags-in-the-early-detection-of-cancer-a-systematic-review/331552.png","ImageObject",300,407,{"name":92,"@type":93},"Seraphina","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-06","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119,123],{"name":110,"@type":111,"acceptedAnswer":112},"What was the main objective of this systematic review?","Question",{"text":113,"@type":114},"To evaluate the diagnostic accuracy of glycosaminoglycans, including heparan sulfate, chondroitin sulfate, and hyaluronic acid, for early detection of cancer.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Which databases and study criteria were used in the review?",{"text":118,"@type":114},"PubMed, Scopus, EBSCO, and Ovid were searched for English studies from the last 15 years, including at least 50 human participants, followed by identification and screening and critical appraisal with CASP and Newcastle-Ottawa Scale.",{"name":120,"@type":111,"acceptedAnswer":121},"What diagnostic performance did heparan sulfate show for renal cancer?",{"text":122,"@type":114},"Heparan sulfate demonstrated high diagnostic potential in renal cancer, with a maximum accuracy of 98.9%, 94.7% specificity, and 100% sensitivity.",{"name":124,"@type":111,"acceptedAnswer":125},"What conclusions does the review draw about GAGs as biomarkers?",{"text":126,"@type":114},"GAGs show potential as early cancer detection biomarkers, but validation is needed in larger, diverse populations to confirm diagnostic accuracy and clinical utility.","https://schema.org",{"og:url":83,"og:type":129,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":131,"canonical":83},"index,follow",{"doc_id":133,"site_id":62},331552,1790167457,{"code":4,"msg":5,"data":136},{"doc_id":133,"user_id":137,"nickname":92,"user_avatar":138,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":139,"file_id":140,"file_url":141,"file_type":142,"file_size":143,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":144,"language":145,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":146,"faqs":147,"seo_title":148,"seo_description":67,"update_tm":149,"read_time":150,"preview_page_count":4},962075114101,"https://ap-avatar.wpscdn.com/avatar/e000253a75eb197efd?x-image-process=image/resize,m_fixed,w_180,h_180&k=1780044092746381165","Submitted 8 July 2024  \nAccepted 16 October 2024 Published 21 November 2024  \nCorresponding author  \nNatheer H. Al-Rawi, [nhabdulla@sharjah.ac.ae](nhabdulla@sharjah.ac.ae)[ ](nhabdulla@sharjah.ac.ae)Academic editor Barbara Bartolini  \nAdditional Information and Declarations can be found on page 19  \nDOI 10.7717/peerj.18486  Copyright  \n2024 Douglah et al.  \nDistributed under  \nCreative Commons CC-BY 4.0  \nThe diagnostic utility of glycosaminoglycans (GAGs) in the early detection of cancer: a systematic review  \nSarah Douglah, Reem Khalil, Reem Kanaan, Moza Almeqbaali, Nada Abdelmonem, Marc Abdelmessih, Yousr Khairalla and Natheer H. Al-Rawi  \nOral & Craniofacial Health Sciences, University of Sharjah, Sharjah, United Arab Emirates  \nABSTRACT  \nBackground: Glycosaminoglycans (GAGs) are a family of polysaccharides found abundantly in the extracellular matrix (ECM) of tissues. Research has indicated that the dysregulation of ECM, including changes and disruptions in GAGs, contributes to various cancer hallmarks such as metabolic reprogramming, persistent growth signals, immunosuppression, angiogenesis, tumor invasion, and metastasis. Objective: This systematic review aims to evaluate the diagnostic accuracy of GAGs, including heparan sulfate (HS), chondroitin sulfate (CS), and hyaluronic acid (HA), in early detection of cancer.  \nMethod: Four databases (PubMed, Scopus, EBSCO, and Ovid) were searched for studies in English within the last 15 years, involving at least 50 human participants. Using a two-stage process: identification and screening, 11 articles were selected and critically appraised using Critical Appraisal Skills Programme (CASP) checklists and Newcastle-Ottawa Scale (NOS) appropriate for each study design.  \nResult: Eleven studies met the inclusion criteria, encompassing various cancers like renal cell carcinoma (RCC), upper GI cancer (UGI), ovarian cancer, prostate cancer, breast cancer, lung cancer, colorectal cancer and oral cancer. Methodological quality was assessed using two established tools, with no studies exhibiting a high risk of bias. Heparan sulfate levels showed diagnostic potential in renal cancer with a maximum accuracy of 98.9%, achieving 94.7% specificity and 100% sensitivity. Chondroitin sulfate disaccharides emerged as a promising diagnostic marker in ovarian cancer and showed potential as diagnostic markers in renal cancer. However, there were no statistically significant differences in urinary chondroitin sulfate levels between patients and controls in prostate cancer. In breast cancer, hyaluronic acid showed moderate accuracy (AUC = 0.792) in distinguishing metastatic from non-metastatic disease, and a composite score incorporating multiple markers, including HA, showed even higher accuracy (AUC = 0.901) in detecting metastatic breast cancer. HA demonstrated moderate diagnostic accuracy for UGI cancers. Serum HA levels were significantly elevated in patients with oral cancer and pleural malignant mesothelioma and associated with tumor progression in patients with lung cancer. Elevated low molecular weight form of hyaluronan (~6 k Da HA) levels were found in colorectal cancer tissues.  \nConclusion: GAGs hold potential as early cancer detection biomarkers. Further validation with larger, diverse populations is needed to validate their diagnostic accuracy and clinical utility.  \nHow to cite this article Douglah S, Khalil R, Kanaan R, Almeqbaali M, Abdelmonem N, Abdelmessih M, Khairalla Y, Al-Rawi NH. 2024. The diagnostic utility of glycosaminoglycans (GAGs) in the early detection of cancer: a systematic review. PeerJ 12:e18486  \nDOI 10.7717/peerj.18486  \nSubjects Biochemistry, Cell Biology, Oncology, Pathology  \nKeywords Gycosaminoglycans, Heparan sulfate, Chondroitin sulfate, Hyaluronic acid, Cancer  \nINTRODUCTION  \nEarly detection of cancer is a critical factor in improving patient outcomes and reducing mortality rates (Ahlquist, 2018) . In this context, there is an increasing interest in the ident","cbCaiooJt9K6vIuS","https://ap.wps.com/l/cbCaiooJt9K6vIuS","pdf",2484164,22,"English","# Abstract\n# Introduction\n# Background\n# Objective\n# Method\n# Result\n# Conclusion","[{\"question\":\"What was the main objective of this systematic review?\",\"answer\":\"To evaluate the diagnostic accuracy of glycosaminoglycans, including heparan sulfate, chondroitin sulfate, and hyaluronic acid, for early detection of cancer.\"},{\"question\":\"Which databases and study criteria were used in the review?\",\"answer\":\"PubMed, Scopus, EBSCO, and Ovid were searched for English studies from the last 15 years, including at least 50 human participants, followed by identification and screening and critical appraisal with CASP and Newcastle-Ottawa Scale.\"},{\"question\":\"What diagnostic performance did heparan sulfate show for renal cancer?\",\"answer\":\"Heparan sulfate demonstrated high diagnostic potential in renal cancer, with a maximum accuracy of 98.9%, 94.7% specificity, and 100% sensitivity.\"},{\"question\":\"What conclusions does the review draw about GAGs as biomarkers?\",\"answer\":\"GAGs show potential as early cancer detection biomarkers, but validation is needed in larger, diverse populations to confirm diagnostic accuracy and clinical utility.\"}]","The diagnostic utility of glycosaminoglycans (GAGs) in the early detection of cancer - a systematic review | PDF",1789993941,55]