TUMOR-ASSOCIATED TRYPSIN-INHIBITOR (TATI) - COMPARISON WITH CA125 AS A PREOPERATIVE PROGNOSTIC INDICATOR IN ADVANCED OVARIAN-CANCER

We have evaluated the prognostic value of tumour-associated trypsin in hibitor (TATI) in stage III or IV ovarian cancer. Tumour-associated tr ypsin inhibitor (TATI) and CA 125 were determined in serum samples fro m 66 patients taken before primary surgery. TATI was elevated (> 22 mu g 1(-1)) in 27 patients (41%). These had a 5 year cumulative survival of 8%, whereas survival was 45% in 39 patients with normal preoperati ve TATI values. By contrast, the preoperative CA 125 level did not pre dict survival. In multivariate analysis which included age, stage, his tological grade and preoperative TATI and CA 125 levels, patients with elevated preoperative TATI levels had a 2.3-fold relative risk of dea th (95% confidence interval 1.23-4.20; P = 0.002) compared with patien ts with normal preoperative levels. This result was comparable with th e predictive value of primary residual tumour size, since patients wit h residual tumour larger than 2 cm in diameter had a 5.2-fold relative risk of death (95% confidence interval 2.55-10.68) compared with pati ents with a smaller or no residual tumour. Thus, preoperative determin ation of serum TATI may have a place in the pretreatment evaluation of patients with advanced ovarian cancer.