The clinical value of tissue polypeptide antigen in patients with gynecologic tumors.

Tissue polypeptide antigen (TPA) was measured by radioimmunoassay in sera from patients with various gynecologic tumors: 64 uterine myomas, 129 cervical cancers, 31 endometrial cancers, and 173 ovarian tumors (89 benign, 18 low-grade malignant (LGM) and 66 malignant tumors). Among the cervical cancer patients, the incidence of elevated TPA levels increased with stage of disease from 12% in the preinvasive stage to 67% in the advanced stage. Similarly, the TPA values were elevated in 35% of the endometrial cancer patients. Among the patients with ovarian malignancies, serum TPA was elevated in the following order: LGM cases (33%), Stage I (44%), and advanced (88%). Serum TPA values varied directly with the stage and malignancy of disease, and also correlated with the effect of treatment. However, serum TPA was elevated in 22% of the patients with uterine myoma and in 12% of those with ovarian benign tumors. The current observations demonstrate that the lack of tumor specificity of TPA limits its diagnostic value in gynecologic malignancies, but that serial measurements of this antigen appear to be useful for the evaluation of therapy and monitoring of patients.