Tumour-associated trypsin inhibitor (TATI) in ovarian cancer.

Tumour-associated trypsin inhibitor (TATI) is a 6 kD peptide isolated from the urine of a patient with ovarian cancer. Increased urinary excretion of TATI has earlier been observed in patients with gynaecological malignancies. The value of TATI in urine and serum as a marker for ovarian cancer was studied in 102 patients. Preoperatively urine TATI was elevated in 55% (18/33) and serum TATI in 27% (12/45) of the patients. In patients with mucinous tumours, elevated preoperative levels of TATI were observed in 6 out of 10 patients, while CA 125 was elevated in 4 and CEA in one of the cases. When assay of TATI was used to predict presence of disease before second-look surgery of 48 patients, the sensitivity and specificity of serum TATI was 19% and 91%, and that of urine TATI 42% and 76%, respectively. Rising TATI levels were observed in progressive disease, whereas regressive disease was not as often associated with falling levels. Serum TATI was elevated in 45% (144/318) and urine TATI in 57% (73/171) of samples from patients with clinical evidence of disease. The TATI assay was found to be of potential value in the management of patients with mucinous ovarian cancer, but in patients with non-mucinous ovarian cancer it did not provide information additional to that obtained from assay of ovarian cancer marker CA 125 alone.