摘要目的:探讨老年皮肤癌患者血清可溶性Fas、FasL水平及临床意义。方法:选择浙江省诸暨市人民医院和浙江省人民医院2014年1月至2017年12月住院手术治疗的老年皮肤癌患者82例作为皮肤癌组，选择同期健康体检老年人82例作为对照组。采用双抗夹心酶联免疫吸附法（ELISA法）测定两组血清sFas、sFasL水平，并进行比较。结果:皮肤癌组血清sFas、sFasL水平均高于对照组[（21.06 ± 3.23）μg/L比（5.64 ± 1.18）μg/L、（14.52 ± 3.42）μg/L比（3.27 ± 0.96）μg/L]，差异有统计学意义（ t=40.606、28.679， P<0.05）。皮肤癌患者血清sFas、sFasL水平与病理分级和淋巴结转移关系密切，病理分级Ⅲ~Ⅳ级患者血清sFas、sFasL水平高于Ⅰ~Ⅱ级患者[（23.57 ± 3.16）μg/L比（16.35 ± 3.62）μg/L、（17.16 ± 3.29）μg/L比（12.15 ± 3.58）μg/L]，差异有统计学意义（ t=8.931、6.173， P<0.05）；有淋巴结转移患者血清sFas、sFasL水平高于无淋巴结转移患者[（24.09 ± 3.46）μg/L比（14.37 ± 3.19）μg/L、（18.17 ± 3.64）μg/L比（11.02 ± 3.27）μg/L]，差异有统计学意义（ t=13.124、9.306， P<0.05）；皮肤癌患者血清sFas、sFasL水平与年龄、性别、部位、类型无关（ P>0.05）。皮肤癌患者治疗后血清sFas、sFasL水平低于治疗前[（7.94 ± 1.21）μg/L比（21.06 ± 3.23）μg/L、（5.38 ± 1.02）μg/L比（14.52 ± 3.42）μg/L]，差异有统计学意义（ t=34.445、23.191， P<0.05）。 结论:老年皮肤癌患者血清sFas、sFasL水平升高，血清sFas、sFasL水平与老年皮肤癌患者的病理分级、淋巴结转移关系密切，可评估临床疗效。

abstractsObjective:To investigate the serum levels of soluble Fas (sFas) and soluble FasL (sFasL) in elderly patients with skin cancer and its clinical significance.Methods:Eighty-two elderly skin cancer patients who underwent surgical treatment in Zhuji People′s Hospital and Zhejiang Provincial People′s Hospital from January 2014 to December 2017 were selected as the skin cancer group, and 82 healthy elderly patients were selected as the control group. The serum sFas and sFasL levels were determined by double anti sandwich enzyme linked immunosorbent assay (ELISA).Results:The serum levels of sFas and sFasL in the skin cancer group were higher than those in the control group [(21.06 ± 3.23) μg/L vs. (5.64 ± 1.18) μg/L, (14.52 ± 3.42) μg/L vs.(3.27 ± 0.96) μg/L], there were significant differences ( t=40.606, 28.679, P<0.05). The serum sFas and sFasL levels were closely related to pathological grade and lymph node metastasis. The serum levels of sFas and sFasL in patients with pathological grade Ⅲ-Ⅳ were higher than those at grade Ⅰ-Ⅱ [(23.57 ± 3.16) μg/L vs. (16.35 ± 3.62) μg/L, (17.16 ± 3.29) μg/L vs. (12.15 ± 3.58) μg/L], there were significant differences ( t=8.931, 6.173, P<0.05). The serum levels of sFas and sFasL in patients with lymph node metastasis were higher than those without lymph node metastasis [(24.09 ± 3.46) μg/L vs. (14.37 ± 3.19) μg/L, (18.17 ± 3.64) μg/L vs. (11.02 ± 3.27) μg/L], there were significant differences ( t=13.124, 9.306, P<0.05). The serum sFas and sFasL levels were not associated with age, gender, location and type ( P>0.05). The serum sFas and sFasL levels after treatment were lower in patients with skin cancer than before treatment [(7.94 ± 1.21) μg/L vs. (21.06 ± 3.23) μg/L, (5.38 ± 1.02) μg/L vs. (14.52 ± 3.42) μg/L], there were significant differences ( t=34.445, 23.191, P<0.05). Conclusions:Serum sFas and sFasL levels are elevated in elderly skin cancer patients. The serum sFas and sFasL levels are closely related to pathological grade and lymph node metastasis in elderly skin cancer patients, and the clinical efficacy can be evaluated.