TUMOR-ASSOCIATED TRYPSIN-INHIBITOR IN THE DIAGNOSIS OF PANCREATIC-CARCINOMA

The serum values of tumour-associated trypsin inhibitor (TATI) were me asured in a prospective series of 97 patients with jaundice, 36 patien ts with unjaundiced cholestasis and 21 patients with suspicion of chro nic pancreatitis or a pancreatic tumour, to assess its value in diagno sing pancreatic cancer. There were altogether 15 patients with cancer of the pancreas and 2 patients with cancer of the papilla of Vater. Th e. highest serum TATI values were noticed in patients with choledochol ithiasis, and raised values were also seen in patients with malignant disease of the liver or bile ducts. In the patients with pancreatic ca ncer, chronic pancreatitis or benign liver disease, the serum TATI val ues showed lower levels. The sensitivity of TATI in diagnosing pancrea tic cancer was 41.1 % with a specificity of 63.5% and an efficiency of 61.0%. In comparison to carcinoembryonic antigen (CEA), carbohydrate antigens CA 50, CA 242, tissue polypeptide antigen and tissue polypept ide-specific antigen, TATI showed a lower diagnostic value. When TATI was analysed in combination with the other markers (two tests positive ), the combination of CEA with TATI reached the highest specificity (9 5.6%), efficiency (89.6%) and positive likelihood ratio (9.3). The res ults suggest that the diagnostic value of TATI is inferior to that of the established markers, but because of its different nature, it may b e of help when used in combination as a complementary serum tumour mar ker in the diagnosis of pancreatic cancer.