Serum Levels of Soluble Forms of Fas and FasL in Patients with Pancreatic and Papilla of Vater Adenocarcinomas

Objective: Impairment of the Fas/FasL apoptotic pathway is a mechanism contributing to the malignant transformation of multiple cell types The aim of this study was to evaluate the clinical usefulness of soluble forms of both Fas receptor (sFas) and its ligand (sFasL) in the serum of patients with pancreatic and papilla of Vater adenocarcinomas. Methods: Soluble levels of Fas and FasL were measured by an ELISA in the serum of 53 healthy controls and in 82 pancreatic and in 14 Vater carcinoma patients both before surgery and 30 days after surgery. The association between preoperative levels, clinicopathological features and patient survival, and their changes following surgery were evaluated. Results: Cancer patients had significantly higher sFas and lower sFasL levels compared to healthy controls and correlated significantly with both lymph node and distant metastases and advance disease stage. Elevated sFas and decreased sFasL levels correlated significantly with poor overall survival with sFas being an independent prognostic factor. Following radical tumor resection preoperative sFas levels decreased whereas sFasL levels increased. These levels remained unchanged in cases of unresectable disease. Conclusions: Increased sFas secretion by pancreatic or Vater adenocarcinomas could contribute to the escape of cancer cells from apoptosis induction. Serum levels of sFas and sFasL could be useful tumor markers with prognostic value for pancreatic or Vater adenocarcinomas.