Serum soluble Fas levels in ovarian cancer

Objective: To determine the value of serum soluble Fas levels as a prognost ic marker for survival of women with ovarian cancer and as a discriminator between benign and malignant adnexal masses. Methods: Serum soluble Fas levels were measured with an enzyme-linked immun osorbent assay in 52 women with ovarian cancer, 30 women with benign ovaria n cysts, and 35 healthy women. Results: Median serum soluble Fas levels in women with ovarian cancer, wome n with benign ovarian cysts, and healthy women were 3.7 (range 1.6-14.5), 2 .3 (range 1.3-4.1), and 1.5 ng/mL. (range 0.1-5.6), respectively (P <.001). A univariate logistic regression model showed a significant influence of s erum soluble Fas and CA 125 levels on the odds of presenting with ovarian c ancer versus benign cysts (P <.001 and P =.001, respectively). In a multiva riable logistic regression model for soluble Fas and CA 125, both markers s howed a statistically significant influence on the odds of presenting with ovarian cancer versus benign cysts (P =.01 and P =.01, respectively). Incre ased pretreatment serum soluble Fas levels were associated with shortened d isease-free and overall survival (P =.002 and P =.001, respectively). A mul tivariable Cox regression model identified serum soluble Fas levels as a si gnificant prognostic factor for disease-free and overall survival, independ ent of tumor stage (P =.04 and P =.03, respectively). Conclusion: Soluble Fas levels might be useful as a discriminator between b enign ovarian cysts and ovarian cancer, adding to the information obtained with the use of the established tumor marker CA 125. Pretreatment serum sol uble Fas levels also might be an independent prognostic factor for disease- free and overall survival. (Obstet Gynecol 2000;96:65-9. (C) 2000 by The Am erican College of Obstetricians and Gynecologists.).