Prognostic significance of soluble fas and soluble fas ligand in serum of patients with complete hydatidiform moles.

PROBLEM: Despite of advances in diagnosis and staging, the prognosis of hydatidiform mole (HM) remains intricate. HM possesses the substantial risk of developing persistent trophoblastic disease (PTD), which is considerably high for complete hydatidiform moles (CHMs). Significance of serum soluble Fas (sFas) and soluble FasL (sFasL) has been observed in various malignancies; however, there is no report till date on HM.

METHOD OF STUDY: The serum levels of sFas and sFasL were measured using enzyme-linked immunosorbent assay in 62 patients with CHMs and 64 healthy controls. The protein concentrations were also correlated with clinicopathological parameters, β-hCG level, and clinical outcome.

RESULTS

The serum sFas and sFasL levels in patients with CHM were significantly higher than those in control group (mean±SD: 703.497±491.759 versus 348.141±175.24; P<0.004 and 31.17±18.758 versus 18.802± 6.775; P<0.0001, respectively). Patients who progressed to PTD demonstrated higher sFas and sFasL concentrations than those who regressed spontaneously (794.211±415.892 versus 446.69±161.382; P<0.046 and 37.55±20.337 versus 22.763±6.52; P<0.011, respectively). Furthermore, significant associations were observed among sFas, sFasL, and β-hCG levels (P<0.0001 for all associations).

CONCLUSION

Production of sFas and sFasL may play a crucial role in progression of CHM and may serve both as prognostic tool and therapeutic target in improving the clinical outcome.