Serum sFas and Tumor Tissue FasL Negatively Correlated with Survival in Egyptian Patients Suffering from Breast Ductal Carcinoma

Abstract

Fas (CD95-APO-1), a member of tumor necrosis factor receptor super-family, exists in two forms, transmembrane and soluble (sFas). It had been suggested that circulating sFas levels and/or tissue FasL may reflect the severity of invasive breast ductal carcinoma. Few studies showed that neither DNA-index nor ploidy is an independent prognostic indicator, and there is no correlation with clinical outcome. The S-phase fraction (SPF) has been shown to be useful prognostic factor in both node-negative and node-positive tumors. The present work was done to find a correlation between sFas, tissue FasL, ploidy and SPF with prognostic factors and survival of breast ductal carcinoma patients. The present study included two groups; a patients group comprised 30 patients with breast ductal carcinoma and a control group that comprised 15 patients with benign breast swellings. Serum sFas was measured using commercially available ELISA kit and tissue FasL expression was studied using avidin-biotine immunohistochemical staining technique. Cell cycle studies were performed using flow cytometry. Serum sFas was significantly higher in breast ductal carcinoma group than in the benign breast swelling control group. A significant negative correlation between serum sFas and overall survival was found. Tissue FasL expression was directly correlated with distant metastasis and poor overall survival. A significant direct correlation was found between moderate and high SPF with worse pathologic parameters. Serum sFas level, tissue FasL immuno-expression and S-phase fraction are independent prognostic factors in breast ductal carcinoma cases.