Clinical applications of glycomic approaches for the detection of cancer and other diseases.

New glycomic approaches are being developed for clinical applications. Technologies that include microcapillary chromatography, lectin affinity chromatography, carbohydrate microarray and mass spectrometry (MS) enable better glycan analysis and are contributing to drug discovery, clinical assays and basic research efforts. More importantly, new glycomic approaches are contributing to our increased understanding of the underlying biology that is responsible for the development, progression and metastasis of cancer. In fact, disruption of part of the glycosylation process in mice has resulted in higher tumor formation in these animals. MS and lectin affinity methods are rapidly replacing traditional biochemical separation and enzymatic procedures for the analysis of oligosaccharides. These technologies are leading to faster and more clinically adaptable tests with greater sensitivity and specificity than currently used tests. Glycomics is also expected to be important in developing better analytical methods for the detection of cancer. It shows promise for personalized medicine since the heterogeneity and complexity of glycosylation reflect the genetic, environmental, lifestyle and nutritional states of each patient, as well as their ethnicity and age. A major challenge facing glycomics and any systems biology approach, will be the ability to accurately profile the glycosylation state of a patient and, based on this profile, to identify if a disease is present, the type of disease and determine the appropriate treatment for the individual patient. Therefore a comprehensive approach to personalized clinical medicine may include a glycomic analysis of clinical samples and could be used in addition to genetic, gene expression and proteomic analyses already being evaluated for clinical use.