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

## TL;DR

This study found that altered levels of sFas and sFasL in the blood may serve as tumor markers and predict outcomes in pancreatic and papilla of Vater cancers.

## Contribution

The study identifies sFas and sFasL as potential biomarkers for prognosis in pancreatic and papilla of Vater adenocarcinomas.

## Key findings

- Higher sFas and lower sFasL levels were observed in cancer patients compared to healthy controls.
- Altered sFas/sFasL levels correlated with metastases, advanced disease stage, and poor survival in pancreatic cancer patients.
- sFas levels decreased and sFasL levels increased after successful tumor resection.

## Abstract

Impairment of the Fas/FasL apoptotic pathway is a mechanism contributing to malignant transformation and may facilitate immune escape by reducing apoptosis. We evaluated the serum levels of soluble forms of Fas receptor (sFas) and its ligand (sFasL) in patients with pancreatic and papilla of Vater adenocarcinomas as well their changes after surgery. The results showed higher sFas and lower sFasL levels in cancer patients compared to healthy controls. These levels correlated with lymph node and distant metastases and advanced disease stage, as well as their changes associated with resectional surgery. Altered levels of sFas and sFasL and sFas/sFasL ratio correlated with poor overall survival of pancreatic carcinoma patients. These findings suggest that serum levels of sFas and sFasL could be useful tumor markers in pancreatic or papilla of Vater adenocarcinomas and may reflect a mechanism of escape of cancer cells from apoptosis induction.

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.