Prognostic significance of a combination of soluble Fas and soluble Fas ligand in the serum of patients with Ta bladder cancer

Recurrence after transurethral resection is one of the major problems in the treatment of superficial bladder cancer. However, there are no potent prognostic markers for recurrence in superficial bladder cancer at present. As circulating soluble Fas (sFas) and soluble Fas ligand (sFasL) have been implicated in protection from Fas-mediated apoptosis against cancers and may interfere with immune surveillance against autologous cancers, sFas and sFasL in the serum of patients with Ta bladder cancer were evaluated as prognostic tumor markers for recurrence. The serum levels of sFas and sFasL were measured by an enzyme-linked immunosorbent assay. Patients with Ta bladder cancer with low serum levels of both sFas and sFasL had a significantly longer postoperative tumor free interval than those with high serum level of either sFas or sFasL in the 3-year follow-up. There was no correlation between the serum levels of sFas and sFasL. The present study has demonstrated that elevated serum sFas or sFasL predicts early recurrence in patients with Ta bladder cancer. These findings suggest that the serum levels of sFas and sFasL can be used as a prognostic indicator for recurrence in patients with Ta bladder cancer, and that sFas and sFasL may independently inhibit Fas-mediated apoptosis.