Abstract
The levels of tumour-associated trypsin inhibitor (TATI), CA 125 and CEA were measured in ovarian cyst fluids from 21 patients. TATI in cyst fluid was immunologically and physicochemically similar to the peptide originally isolated from the urine of a patient with ovarian cancer. Mucinous cysts contained significantly higher levels of TATI than did serous cysts. Immunohistochemically TATI was localized in the apical parts of cells of mucinous ovarian cysts. These results suggest that this tumour-associated peptide is actually produced by a tumour. Like TATI, CEA occurred at higher concentrations in mucinous than in serous cyst fluids, whereas CA 125 was found in higher concentrations in serous than in mucinous cyst fluids. The concentrations of these tumours markers in cyst fluids did not correlate with circulating levels of the same markers. In spite of the very high levels of all these tumour markers in benign cyst fluids, serum levels were normal or only slightly elevated. Clearly elevated serum levels occurred only in patients with malignant tumours. Cyst fluid levels of these tumour markers could not be used to distinguish between benign and malignant tumours.
Highlights
Serum and urine with a high content of tumour-associated trypsin inhibitor (TATI) were obtained from patients with advanced ovarian cancer
No significant differences were found in the cyst fluid TATI levels between benign and borderline or malignant cysts
Serum levels of TATI were normal in most patients with mucinous cysts in spite of about 1,000-fold levels in cyst fluid compared to serum
Summary
Cyst fluid was obtained during operation from 21 patients with ovarian cystic tumours. These included 10 benign mucinous cystadenomas, I borderline and I malignant mucinous tumour; 4 benign serous cystadenomas, 1 borderline and 4 malignant serous tumours. Serum samples were available from 15 of these patients. Cyst fluid and serum samples were stored at -20'C until assayed. Serum and urine with a high content of TATI were obtained from patients with advanced ovarian cancer. TATI was purified from urine of a patient with ovarian cancer (Huhtala et al, 1982)
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