Tumor-associated Trypsin Inhibitor Levels Research Articles

Tumor-associated trypsin inhibitor (TATI) and tumor-associated trypsin-2 (TAT-2) predict outcomes in gastric cancer

Introduction: Tumor-associated trypsin inhibitor (TATI) limits serine proteases, promotes carcinogenesis in several cancers and functions as an acute-phase reactant. Tumor-associated trypsin-2 (TAT-2), a proteolytic target enzyme for TATI, can enhance invasion by promoting extracellular matrix degradation. Here, we aimed to study serum TATI and TAT-2 levels, including the TAT-2/TATI ratio, as prognostic and diagnostic biomarkers in gastric cancer. We compared the results with the plasma level of C-reactive protein (CRP).Material and Methods: We selected 240 individuals operated on for gastric adenocarcinoma at the Helsinki University Hospital, Finland, between 2000 and 2009. We determined the preoperative serum TAT-2, TATI and plasma CRP levels using time-resolved immunofluorometric assays using monoclonal antibodies.Results: The medium serum TAT-2 level was higher among gastric cancer patients [8.68 ng/ml; interquartile range (IQR) 5.93–13.2] than among benign controls (median 5.41 ng/ml; IQR 4.12–11.8; p = .005). Five-year survival among patients with a high serum TAT-2 was 22.9% [95% confidence interval (CI) 11.7–34.1], compared to 52.2% (95% CI 44.6–59.8; p < .001) among those with a low level. The five-year survival among patients with a high serum TATI was 30.6% (95% CI 20.4–40.8), compared to 52.9% (95% CI 44.7–61.1; p < .001) among those with a low level. The serum TATI level remained significant in the multivariable survival analysis (hazard ratio 2.01; 95% CI 1.32–3.07). An elevated plasma CRP level associated with a high serum TATI level (p = .037).Conclusions: This study shows for the first time that a high serum TAT-2 may function as a prognostic biomarker in gastric cancer and that TAT-2 levels may be elevated compared to controls. Additionally, we show that the prognosis is worse among gastric cancer patients with a high serum TATI. These biomarkers serve as prognostic factors particularly among patients with a metastatic or a locally advanced disease.

Monitoring the treatment outcome in endometrial cancer patients by CEA and TATI.

An attempt was made to compare the usefulness of determining markers carcinoembryonic antigen (CEA) and tumor-associated trypsin inhibitor (TATI) in endometrial cancer patients in whom recurrence or distant metastasis was diagnosed in observation after treatment. The study included 316 patients aged 32–81, average age of 61 years, SD = 8.72, with diagnosed endometrial cancer, treated between 1994 and 1995 at the Oncology Center in Warsaw and then under observation from 4 months to 17 years after completion of treatment. The levels of the markers TATI and CEA were assessed from the first five serum samples taken during postoperative radiotherapy and in the initial period of observation after completed treatment. Receiver operating characteristic (ROC) curves were generated, determining the sensitivity and specificity of both CEA and TATI in patients who experienced treatment failure, i.e., recurrence and distant metastasis. Assessing the sensitivity of the marker CEA, it was found that if in the third sample, i.e., during radiation therapy, the marker level increased by more than 20 % compared with the first sample, then recurrence of cancer occurred during the observation period in 75.9 % of patients and metastatic occurred in 69.7 % of patients. In the evaluation of the marker TATI, it was found that if the level of TATI between the first and the third sample increases by 10.6 % from the initial level, then in 84.4 % (sensitivity) of cases, this means the occurrence of cancer recurrence and in 75.7 % (sensitivity) of cases, the occurrence of metastasis. The specificity of both markers is low and not useful diagnostically.

Tumor-associated trypsin inhibitor in patients with endometrial cancer.

The aim of the study was to look for prognostic factors of metastasis or recurrence in patients with endometrial cancer. Tumor-associated trypsin inhibitor (TATI) concentrations were measured in serum of 317 patients with endometrial cancer. The assay was done 7 times in each patient, from the moment of diagnosis until the start of follow-up after the completion of treatment. Observation of patients after treatment lasted from 0 to 16 years. The TATI levels in patients with adverse prognostic factors accumulated in the first 3 assays and then decreased to zero. Mean TATI concentrations were significantly higher in patients with clinically advanced disease (stage IIIB) than patients at stage I (Kruskal-Wallis p = 0.0446). An increase in the concentration by more than 10.6% in the first 3 assays was significantly correlated with disease relapse (Mann-Whitney Z = -6.06653, p = 0.00000) and local or distant recurrence (Mann-Whitney Z = -4.97475, p = 0.000001). A significant increase in the TATI level in the first 3 tests also occurred in patients who died during the study period (Kruskal Wallis p&lt;0.001). In our series of patients with endometrial cancer, TATI proved to be a sensitive indicator of disease recurrence and distant metastasis, with a sensitivity of 84.4% and 75.7%, respectively. TATI seems to behave as a prognostic factor in certain subgroups of patients with endometrial cancer.

Creatinine clearance, cystatin C, beta2-microglobulin and TATI as markers of renal function in patients with proteinuria

Proteinuria is a risk factor for end-stage renal disease (ESRD). Creatinine clearance (CrCl) is usually used as a marker to monitor the progression of ESRD, while cystatin C (CYST) has also been considered as a marker of renal function. Tumor-associated trypsin inhibitor (TATI) has been shown to be a promising marker of renal function. The aim of this study was to examine the relationship between CrCl, CYST, ß(2)-microglobulin (B2M) and TATI, with glomerular filtration rate (GFR) in patients with different levels of proteinuria. Seventy-one patients (37 males, 34 females, mean age 53 ± 15 years) were included in the study. GFR was measured by the bladder cumulative method using (99m)Tc-DTPA. Blood levels of CYST, B2M and TATI were also measured. CrCl and proteinuria were determined by 24-hour urine collection. Statistical analysis was performed with multivariate analysis. The results are expressed as the ratio to GFR of CrCl and reciprocals of CYST (100/CYST), B2M (100/B2M) and TATI (100/TATI). The ratio CrCl/GFR increased from 1.41 in patients with proteinuria <1 g/day, to 1.66 (p<0.05) in those with proteinuria >3 g/day. The ratio 100/CYST/GFR was 1.67 and 2.28 (p<0.05), 100/B2M/GFR 0.90 and 0.69 and 100/TATI/GFR 0.14 and 0.19, respectively. Multivariate analysis demonstrated that ClCr/GFR as well as 100/CYST/GFR was independently related to the degree of proteinuria. CrCl and CYST overestimate GFR in patients with heavy proteinuria, while the ratios 100/TATI and 100/B2M with GFR do not significantly change. The direct measurement of GFR still remains the best method to assess the progression of renal damage in patients with heavy proteinuria.

Evaluation of Urine Tumor-Associated Trypsin Inhibitor, CYFRA 21-1, and Urinary Bladder Cancer Antigen for Detection of High-Grade Bladder Carcinoma

To assess the value of urine tumor-associated trypsin inhibitor (TATI), CYFRA 21-1, which measures cytokeratin 19 fragment, and urinary bladder carcinoma antigen (UBC) for the detection of high-grade bladder carcinoma. A total of 160 individuals were enrolled in the present study. Of these, 80 were patients with proven primary high-grade urothelial bladder cancer (group 1), 40 were healthy volunteers (group 2), and 40 had history of benign urologic disease (group 3). All were evaluated with respect to urinary TATI, CYFRA 21-1, and UBC levels. All these markers were evaluated using commercial kits. Cytology was also performed. The TATI measurements were significant greater in group 1 compared with groups 2 and 3. The cutoff point used for TATI, CYFRA 21-1, and UBC was 22, 2.8, and 12 microg/L, respectively. The overall sensitivity was 85.7% for TATI, 61.9% for CYFRA 21-1, 50% for UBC, and 42.8% for cytology. TATI was significantly more sensitive in Stage Ta (80%) than was CYFRA 21-1 (32%), UBC (12%), and cytology (20%). TATI was also more sensitive compared with other tumor markers for Stage T1 but not for Stage T2 or T3. The results of our study have shown that TATI is a promising urinary tumor marker for high-grade urothelial bladder cancer. It is more sensitive than CYFRA 21-1, UBC, and cytology for Stage Ta and T1 bladder cancer.

Comparison of secondary and primary ovarian malignancies reveals differences in their pre- and perioperative characteristics

Objective.Preoperative differentiation of primary and metastatic ovarian tumors is difficult. Young age of the patient, bilateralism and reduced multilocularity are cited characteristics of secondary ovarian malignancies. We sought to identity pre- and perioperative factors which may aid in differentiating metastatic ovarian tumors from primary ovarian malignancies. Patients and methods.We performed a retrospective analysis of demographic parameters, preoperative serum tumor marker levels and ultrasonographic as well as operative findings in 38 patients with secondary ovarian malignancies and 76 control patients with primary epithelial ovarian cancer. All patients were treated at our institute from 1996 to 2003. Results.The proportion of secondary ovarian tumors, of all ovarian malignancies, was 5.2%. The most common sites of origin were the gastrointestinal tract (42%), breast (29%) and peritoneum (16%). Fifty-eight percent of the patients with a secondary ovarian tumor had a history of previous malignancy; 42% of the primary malignancies were detected only following diagnosis of ovarian metastasis. The two patient groups (primary or secondary ovarian malignancy) could not be distinguished by age, parity, menopausal status or history of hysterectomy. Of the serum markers, the preoperative level of serum CA 125 was not different between the two groups. Both serum tumor-associated trypsin inhibitor (TATI) (7.2 ± 9.6 vs. 4.7 ± 9.4 μg/l [mean ± SD]) and carsinoembryonic antigen (CEA) levels (19.7 ± 30.8 vs. 6.7 ± 120.0 μg/l) were higher in the group with secondary malignancies (P < 0.02). The metastatic ovarian tumors, as measured preoperatively by ultrasonography (US), were smaller (64 mm, 62–89 mm [median, 95% Cl]) than the primary tumors (105 mm, 104–134 mm) (P < 0.0005). The same was true for tumor sizes measured at surgery (P < 0.05). Furthermore, the secondary tumors were more often solid (50 vs. 10%) (P < 0.005), and more seldom cystic-solid (17 vs. 55%) (P < 0.001). Presence of ascites was more common among patients with primary ovarian malignancies in both preoperative US (P < 0.01) and at operation (P < 0.0001). Bilateralism, presence of adhesions, and carcinosis did not differ between the two groups. Conclusions.When evaluating a patient with an ovarian tumor, a history of malignancy strongly suggests a metastatic nature. Size less than 9 cm, solid structure, absence of ascites and elevated serum CEA and TATI levels were typical features associated with secondary ovarian malignancies.

Urinary Levels of Tumor-Associated Trypsin Inhibitor (TATI) in the Detection of Transitional Cell Carcinoma of the Urinary Bladder

Objective: To assess whether urinary levels of tumor-associated trypsin inhibitor (TATI) would aid in the detection of bladder transitional cell carcinoma (TCC); and to compare diagnostic performance of urinary TATI with that of nuclear matrix protein 22 (NMP22) and barbotage cytology. Methods: We determined TATI and NMP22 levels in voided urine from 181 subjects: 153 with previous bladder cancer, 20 with urologic pathology other than bladder cancer, and eight healthy volunteers. TATI was analyzed continuously and categorically on the basis of its quartile distribution. We also measured urinary creatinine and barbotage cytology in 173 and 154 patients, respectively. Results: Urinary TATI levels were significantly higher in TCC patients with evidence of tumor on cystoscopic evaluation ( n = 96) than in control subjects ( n = 85; p < 0.001). Higher levels of TATI were associated with positive cytology assay results ( p = 0.018), higher NMP22 levels ( p < 0.001), and invasive tumor stage ( p = 0.026). The area under the receiver operating characteristics (ROC) curve (AUC) of TATI for the detection of TCC was 0.712 (95%CI: 0.637–0.786). The overall AUCs for TATI and NMP22 were not statistically different from each other ( p = 0.174). In the >75% sensitivity region of the ROC curves, TATI was consistently more specific than NMP22. TATI, NMP22, and cytology were independently associated with bladder cancer ( p = 0.049, p = 0.040, and p < 0.001, respectively). Adjustment of TATI for urinary creatinine levels did not affect any of the outcomes. Conclusions: Urinary level of TATI may add independent information to urinary cytology and NMP22 in the detection of bladder TCC. TATI seems to outperform NMP22 for bladder TCC detection.

845: Urinary Levels of Tumor-Associated Trypsin Inhibitor (TATI) in the Detection of Transitional Cell Carcinoma of the Urinary Bladder

You have accessJournal of UrologyPodium, Monday, May 23, 2005, 1:00 - 3:00 pm1 Apr 2005845: Urinary Levels of Tumor-Associated Trypsin Inhibitor (TATI) in the Detection of Transitional Cell Carcinoma of the Urinary Bladder Shahrokh F. Shariat, Mike Herman, Roberto Casella, Yair Lotan, Jose Karam, and Ulf-Håkan Stenman Shahrokh F. ShariatShahrokh F. Shariat More articles by this author , Mike HermanMike Herman More articles by this author , Roberto CasellaRoberto Casella More articles by this author , Yair LotanYair Lotan More articles by this author , Jose KaramJose Karam More articles by this author , and Ulf-Håkan StenmanUlf-Håkan Stenman More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)35014-6AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "845: Urinary Levels of Tumor-Associated Trypsin Inhibitor (TATI) in the Detection of Transitional Cell Carcinoma of the Urinary Bladder." The Journal of Urology, 173(4S), pp. 229–230 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 173Issue 4SApril 2005Page: 229-230 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Shahrokh F. Shariat More articles by this author Mike Herman More articles by this author Roberto Casella More articles by this author Yair Lotan More articles by this author Jose Karam More articles by this author Ulf-Håkan Stenman More articles by this author Expand All Advertisement Loading ...

Tumor-associated trypsin inhibitor in normal and malignant renal tissue and in serum of renal-cell carcinoma patients.

Tumor-associated trypsin inhibitor (TATI) is a 6-kDa peptide, which is identical to the pancreatic-secretory-trypsin inhibitor (PSTI). TATI is produced by several tumors and cancer cell lines, and is used as a serum marker for mucinous ovarian cancer. Elevated serum levels of TATI have also been observed in renal-cell carcinoma (RCC). However, it is unclear whether the increase of serum TATI in this disease is caused by production of TATI by the tumor tissue, by the acute-phase reaction frequently associated with cancer, or by impaired renal function. We examined the expression of TATI in malignant and histologically normal renal tissue by immunohistochemistry, in situ hybridization and reverse-transcriptase-polymerase-chain reaction (RT-PCR). Furthermore, we measured pre-operative serum TATI levels in 21 patients with RCC. Immunohistochemically, TATI was detected in 13 of 20 histologically normal renal-tissue samples, but not in 32 tissue samples from RCC. By RT-PCR, TATI mRNA was detected in all of 10 histologically normal kidneys and in 6 of 11 RCCs, while in situ hybridization analysis gave negative results. Pre-operative serum TATI was elevated in 57% of RCC patients. We also studied expression of TATI mRNA and protein in 7 renal-cancer cell lines, by RT-PCR and immunofluorometric assay respectively: 6 cancer cell lines were positive for TATI mRNA, while 4 of them also produced TATI protein at low levels. These results indicate that TATI is synthesized by the histologically normal renal tissue and by some renal cancers, and suggest that the elevation of serum TATI associated with renal-cell carcinoma may be caused by the release of TATI produced by the tumor.

Serum tumor markers CEA, CA 50, TATI, and NSE in lung cancer screening.

There are no effective means for screening for lung cancer, so the authors assessed the utility of four lung cancer tumor makers for screening. A case-control study, nested in a cohort study based on the linkage of records of health survey examinees with Finnish Cancer Registry records, was used to test the validity of tumor markers carcinoembryonic antigen (CEA), tumor-associated trypsin inhibitor (TATI), neuron-specific enolase (NSE), and CA 50 in lung cancer screening. Ten years after health examinations, record linkage indicated that 187 men had lung cancer; 344 control subjects, matched for age, sex, and municipality were drawn from the same records. The data allowed assessment of the sensitivity of the marker assays at a 95% specificity level, which was highest for CEA (17% at a concentration level of 5.3 micrograms/l). Logistic discrimination analysis indicated that of the other markers, only TATI, when used in combination, improved the discriminatory power of CEA. CEA and TATI levels correlated significantly with smoking. They also showed a significant gradient toward increasing risk of lung cancer from the lowest to the highest quintiles of marker levels (for CEA, crude relative risk between the highest and lowest quintiles, 8.6). The gradient also was evident in the subgroup whose cancer had been diagnosed more than 5 years after serum specimen collection. The trend persisted, although relative risk was halved after adjustment for smoking. The markers do not seem to be useful tools for lung cancer screening. However, CEA and TATI levels seem to give information on cancer risk long before the clinical cancer stage, as the quintile-based analyses of marker levels indicate.

Tumor-associated trypsin inhibitor and cancer antigen 125 in pelvic masses

Tumor-associated trypsin inhibitor (TATI) and cancer antigen 125 (CA-125) were measured pre- and peroperatively in 183 patients with a pelvic mass to elucidate the value of TATI alone and in combination with CA-125 as a differential diagnostic tool. Malignant tumors were registered in 109 patients (90 ovarian and 19 nonovarian cases), borderline ovarian tumors in 8, and benign tumors in 66 (50 ovarian and 16 nonovarian). The TATI level was increased only in half of the patients with malignant tumors; therefore, the marker cannot be used alone as a preoperative diagnostic tool. In contrast, CA-125 had a sensitivity of 82%, which rose to 91% when the marker was used in combination with TATI. CA-125 and TATI had a combined specificity of 76% and positive and negative predictive values of 87 and 83%, respectively. Our results indicate that TATI measurement substantially improves the preoperative differential diagnostic information obtained with CA-125 and that it does not significantly increase the number of false-positive findings. We recommend the complementary measurement of TATI in patients who have a pelvic mass and a normal CA-125 level.

Tumor-Associated Trypsin Inhibitor (Tati) in Primary Esophageal Carcinoma

Esophageal carcinoma has a catastrophic clinical course with a very low 5 year survival rate of 5%. A circulating tumor marker with good specificity and sensitivity would be useful in the management strategy of the disease. So far, no tumor marker effective in esophageal carcinoma has been identified. Preliminary reports suggest satisfactory positivity rates of tumor-associated trypsin inhibitor (TATI) in esophageal carcinoma. We measured TATI levels in 71 patients with primary squamous cell esophageal carcinoma as well as in 30 tissue samples from both carcinoma and normal esophageal mucosa. Detectable TATI levels were not found in tumor tissue samples. The marker showed significantly higher serum levels in patients than in controls, with an overall positivity rate of 28%. TATI levels were significantly lower in patients with a high number of tumor-positive lymph nodes. No relationship was found between TATI and several other clinical and pathological parameters. High TATI levels correlated with a lower probability of overall survival as well as in cases without clinical evidence of lymph node metastases. TATI did not show any relationship with CEA, TPA, ferritin or SCC. The results of the present study suggest that TATI shows a satisfactory positivity rate in esophageal carcinoma, and TATI levels are related to local disease spread and prognosis.

Comparison of Tumor-Associated Trypsin Inhibitor (Tati) with Ca125 as a Marker for Diagnosis and Monitoring of Epithelial Ovarian Cancer

Preoperative serum levels of CA125 and tumor-associated trypsin inhibitor (TATI) were measured in 220 patients undergoing laparotomy for adnexal masses. Of the 57 patients with epithelial ovarian cancer. 86% had serum CA125 higher than 35 kU/l and 81% higher than 65 kU/l while 51% had serum TATI above 22 micrograms/l. In eight patients with mucinous ovarian malignancies, serum levels of CA125 were above 65 kU/l in 6 cases while serum TATI was above 22 micrograms/l in 4 cases. Of the 163 patients with benign ovarian masses, 41% had serum CA125 levels above 65 kU/l and 17% above 65 kU/l whereas serum TATI was above 22 micrograms/l in 6%. In 11 cancer patients having elevated levels of both CA125 and TATI at diagnosis, the serum concentrations of these antigens were periodically measured during and after treatment. Changes in CA125 and TATI levels correlated with the clinical course in 84% and 37% of the instances, respectively. After the sixth course of chemotherapy, the diagnostic accuracy of the markers in the evaluation of the disease status at second-look laparotomy was 55% for CA125 with a cut-off level of 35 kU/l, 36% for a cut-off level of 65 kU/l, 55% for TATI, and 66% for the combination of CA125 and TATI with cut-off levels of 65 kU/l and 22 micrograms/l. CA125 is the most sensitive marker for epithelial ovarian cancer, but the concomitant measurement of TATI could be of benefit in both differential diagnosis of adnexal masses and monitoring of response of epithelial ovarian cancer to treatment.

Serum Levels of Tumor-Associated Trypsin Inhibitor (Tati) in Benign and Malignant Gynecological Diseases

The behavior of tumor-associated trypsin inhibitor (TATI) as a marker for gynecological cancer was studied in a control population and in patients with different benign and malignant diseases. When a cut-off level of 21.4 micrograms/l was used the specificity was 100% in patients with benign diseases. The sensitivity in patients with malignant tumors was low for cervical and corpus cancer, 13% and 14%, respectively, whereas it was 33% in all the ovarian malignant tumors, reaching 60% in the mucinous type. There was a clear correlation between TATI level and stage.

Tumor-Associated Trypsin Inhibitor in Induced and Acquired Immunodeficiency. Studies on Transplanted and Hiv-Infected Patients

A new tumor marker, tumor-associated trypsin inhibitor (TATI), was studied in 5 patients who received successful kidney or pancreas grafts and in 30 subjects with antibodies against human immunodeficiency virus. Serum TATI concentrations were very high during the four first days after transplantation. Thereafter the serum levels decreased when the peptide was eliminated through the kidney. Consequently, the urine values were very high. The TATI concentrations of HIV positive subjects were compared with serum levels of HIV antigen and antibody, by Western blotting and determination of peripheral T-lymphocyte subpopulations. The occurrence of high concentrations of TATI in some HIV positive subjects and especially in AIDS patients, suggests that TATI could be useful in exploring physiopathological aspects of severe immunodeficiencies even if TATI levels were not correlated with the commonly used markers of the immune system status. The increased levels of TATI in immunological disorders suggests its possible use in assessing the immune response against cancer.

Tumor-Associated Trypsin Inhibitor as a Possible Marker in Male Infertility

The concentrations of tumor-associated trypsin inhibitor (TATI) in the seminal plasma of infertile males was studied. The TATI levels in seminal plasma were not correlated with either sperm count or ejaculate volume. High levels were observed in some men with unexplained infertility and high or normal sperm counts, whereas normal levels were observed in males with antisperm antibodies. The concentrations in seminal plasma were stable in the same subjects. These results suggest that TATI may be an important marker of reproductive pathology in men.

Tumor-Associated Trypsin Inhibitor (Tati) in the Diagnosis of Lung Cancer

To evaluate the usefulness of tumor-associated trypsin inhibitor (TATI) as a marker for the diagnosis of lung cancer we determined serum levels of this peptide in 255 patients with lung cancer and in 74 patients with chronic obstructive lung disease. A reference population consisting of 151 healthy volunteers was also studied. TATI concentrations were measured by radioimmunoassay. As a cut-off point we used the 99th percentile of the TATI concentrations in a reference population, which was 32 micrograms/l. TATI does not appear to be a good tumor marker in lung cancer. Its sensitivity is poor in comparison with CEA and TPA. The correlation between TATI levels and stage of the disease and histological type was weak.

Biology and Function of Tumor-Associated Trypsin Inhibitor, Tati

Tumor-associated trypsin inhibitor (TATI) is a 6,000 Daltons peptide, which is synthesized by several tumors and cell lines. TATI is identical to pancreatic secretory trypsin inhibitor (PSTI). This peptide is also produced by the mucosa of the gastrointestinal tract, where it is thought to protect the mucosal cells from proteolytic breakdown. Elevated serum and urine levels of TATI occur in connection with many types of cancer, especially mucinous ovarian cancer. Elevated levels may also occur in nonmalignant diseases, e.g. in pancreatitis, severe infections and tissue destruction. Thus TATI may behave as an acute phase reactant. Tumors producing TATI often express tumor-associated trypsinogen. Elevation of TATI in cancer and pancreatic disease is therefore associated with expression of trypsin, but such a connection has not been demonstrated in inflammatory disease. TATI can inhibit trypsin-mediated degradation of extracellular matrix by tumor cells. Therefore its role may be to control the activation of tumor-associated trypsinogen. TATI has also been shown to possess growth factor activity in vitro, but it is not known whether this is a physiological function.

Evaluation of Tumor-Associated Trypsin Inhibitor (Tati) in Women with Benign and Malignant Gynecological Disease

Tumor-associated trypsin inhibitor (TATI) was assayed in healthy subjects and in women with benign and malignant gynecological diseases. Significantly lower levels were found in boys than in healthy adult subjects. No variations in level were evident over the course of a 24 h period. At a cut-off level of 20 micrograms/l elevated concentrations were found in 42%, 11.4% and 19% of women with ovarian, endometrial and cervical neoplasia, respectively. In patients with ovarian tumors TATI level were elevated both in mucinous and serous tumors. TATI does not seem to be useful for diagnosis of uterine tumors, but could have a specific place in the study and management of ovarian tumors, in which serum concentrations can reach levels 100-200 micrograms/l. In the other gynecological diseases maximum levels of 30-40 micrograms/l were observed.

Tumor-Associated Trypsin Inhibitor (Tati) in Pleural Effusions

The purpose of this study was to evaluate the usefulness of tumor-associated trypsin inhibitor (TATI) determination in serum and pleural fluid for differential diagnosis of relapsing pleural effusions. The concentrations of TATI were determined in samples of serum and pleural fluid from 51 patients with pleural effusions comprising 20 benign exudates, 5 transudates and 26 malignant effusions. TATI levels overlapped in benign and malignant fluids. This precludes the use of this marker for diagnosis of pleural effusions. For this purpose CEA seems to be the best tumor marker with a sensitivity frequently higher than that of cytology.