Latent transforming growth factor (TGF)binding proteins (LTBPs) play important roles in the secretion and activation of TGF. We previously reported that LTBP-1L is overexpressed in some patients with ovarian cancer. To clarify the molecular mechanism of LTBP-1L regulation, we analyzed DNA sequences in the promoter region of LTBP-1L and identified two novel single nucleotide polymorphisms, 202G/C and 20A/C. While the alleles with 202C and 20C were initially reported, our data demonstrated that 202G and 20A are common in both ovarian cancer patients and healthy patients in the Japanese population. Luciferase reporter assays revealed that the G-A haplotype induced transcriptional activation in a Sp1-dependent manner. Electrophoretic mobility shift assays showed that increased binding affinity of Sp1 to the promoter with 202G and 20A. Interestingly , ovarian cancer patients (n 42) with G-A/G-A homozygous genotype had increased expression of LTBP-1 and apparently poorer survival than those with other genotypes (P 0.02). These findings suggest that the single nucleotide polymorphisms 202G/C and 20A/C on the LTBP-1L promoter may affect the clinical outcome of ovarian cancer patients , probably via up-regulating protein expression. Further studies using a larger number of samples will definitively determine the correlation between LTBP-1 haplotype and clinical behavior of ovarian cancer. (J Mol Diagn 2006, 8:342–350; DOI: 10.2353/jmoldx.2006.050133) Transforming growth factor (TGF)is a potent growth inhibitor for most cell types, including epithelial cells. The secretion of TGFby tumor cells may contribute to tumor suppression by autocrine growth inhibition, but on the other hand, it may also promote tumor progression by stimulating tumor invasion and angiogenesis, and inhibiting immune response. TGFis synthesized as latent high-molecular weight complexes, composed of TGF, the NH2-terminal part of the TGFprecursor, and the latent TGFbinding protein (LTBP). LTBP is a glycoprotein with a molecular weight of more than 190 kd; it possesses 16 to 18 epidermal growth factor (EGF)-like domains and several repeats of a unique motif containing eight cysteine residues. Four isoforms of LTBP have been found in mammalian species (LTBP-1 to LTBP4). LTBP-1 binds to TGF1 through one of the eight cysteine motifs and facilitates assembly and secretion and activation of TGF1. Immunoelectronmicroscopic observations indicate that LTBP-1 is one of the extracellular microfibrillar components; it targets TGF1 to extracellular structures and participates in the activation of latent TGF1, perhaps by concentrating latent TGF1 on the cell surface where activation occurs. LTBP-1S (short) and LTBP-1L (long) are derived from independent promoters and alternative splicing between codons 145 and 146 of LTBP-1S. LTBP-1L has a N-terminal extension of 346 amino acids that is not found in the LTBP-1S. The N-terminal extension contains an EGF-like domain that facilitates matrix incorporation, and LTBP-1L has been confirmed to associate more efficiently than LTBP-1S with the extracellular matrix.