OBJECTIVES: To evaluate the prognostic value of tumor-associated trypsin inhibitor (TATI) in the serum and urine of patients in follow-up for urinary bladder cancer. METHODS: Serum and urine samples were taken during follow-up of 157 patients with transitional cell carcinoma of the bladder who were monitored by cystoscopy and cytology in 1986 to 1987. Initially, 117 (75%) of the 157 tumors were superficial. At the time of sampling, 93 patients (59%) had no detectable tumor and 48 (31%) had a superficial, and 16 (10%) an invasive, tumor. Cancer-specific survival was evaluated in 1998. RESULTS: During follow-up, 35 patients (22%) died of bladder cancer. An elevated TATI concentration in the serum (21 microg/L or more) was associated with a significantly shorter survival (P <0.001) compared with a normal value. Multivariate analysis showed that serum TATI and detectable cancer at sampling were independent prognostic factors (P <0.001 and P = 0.002, respectively), and age, grade, urine cytology findings, and urine TATI were not. CONCLUSIONS: Serum TATI is an independent prognostic factor in transitional cell carcinoma and is potentially useful for the identification of patients with an adverse prognosis.
OBJECTIVES: To evaluate the prognostic value of tumor-associated trypsin inhibitor (TATI) in the serum and urine of patients in follow-up for urinary bladder cancer. METHODS: Serum and urine samples were taken during follow-up of 157 patients with transitional cell carcinoma of the bladder who were monitored by cystoscopy and cytology in 1986 to 1987. Initially, 117 (75%) of the 157 tumors were superficial. At the time of sampling, 93 patients (59%) had no detectable tumor and 48 (31%) had a superficial, and 16 (10%) an invasive, tumor. Cancer-specific survival was evaluated in 1998. RESULTS: During follow-up, 35 patients (22%) died of bladder cancer. An elevated TATI concentration in the serum (21 microg/L or more) was associated with a significantly shorter survival (P <0.001) compared with a normal value. Multivariate analysis showed that serum TATI and detectable cancer at sampling were independent prognostic factors (P <0.001 and P = 0.002, respectively), and age, grade, urine cytology findings, and urine TATI were not. CONCLUSIONS: Serum TATI is an independent prognostic factor in transitional cell carcinoma and is potentially useful for the identification of patients with an adverse prognosis.
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