Spyridon Patris

Objective: Impairment of the Fas/FasL apoptotic pathway is a mechanism contributing to the malignant transformation of multiple cell types. This study aimed to investigate the clinical and prognostic relevance of serum soluble Fas (sFas) and soluble Fas ligand (sFasL) levels in patients with pancreatic and papilla of Vater adenocarcinomas. Methods: An ELISA was used to determine sFas and sFasL levels. Serum samples were obtained from 53 healthy controls, 82 pancreatic and 14 papilla of Vater carcinoma patients. Sera from carcinoma patients were obtained before surgery and 30 days after surgery. The relationships of preoperative levels with clinicopathological features and patient survival were evaluated. Changes in serum sFas and sFasL levels after surgery were also evaluated. Results: Higher sFas and lower sFasL levels were found in the serum of carcinoma patients in comparison to healthy controls. Serum sFas and sFasL levels correlated significantly with both lymph node and distant metastases and an advanced stage of disease. Elevated sFas and decreased sFasL levels correlated significantly with poor overall survival when the entire study population was considered with sFas being an independent prognostic factor. After patient stratification, their prognostic value was evident in pancreatic carcinoma patients only. Preoperative sFas levels decreased and sFasL levels increased after radical resection of the tumor but remained unchanged in cases of unresectable disease. Conclusions: These findings suggest that serum levels of sFas and sFasL could be useful tumor markers with prognostic value in pancreatic adenocarcinomas. Increased sFas secretion may reflect a mechanism for apoptotic escape of cancer cells.

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.