title: TATI (tumor associated trypsin inhibitor) and cancer antigen 125 (CA 125) in patients with early-stage endometrial cancer.
abstract: BACKGROUND
  In patients with gynecologic malignancies, a 6 kD polypeptide known as the tumor-associated trypsin inhibitor (TATI) is present in high concentrations, both in the urine and the serum. This study attempts to evaluate the usefulness of pretreatment serum levels of TATI (cutoff level 21 ng ml-1) and CA 125 (cutoff levels 35 U ml-1 and 65 U ml-1) in the prediction of early endometrial cancer.
  
  
  METHODS
  One hundred twenty-seven patients with stage I and II endometrial carcinomas, 110 healthy women and 258 women with benign pelvic pathologies were evaluated. The data obtained were correlated with the tumor stage and tumor grade.
  
  
  RESULTS
  Overall, TATI showed a sensitivity of 31% and a specificity of 81%. The sensitivity and specificity of CA 125 > 35 U ml-1 was 25% and 86%, respectively. When both serum tumor markers were combined the sensitivity increased to 48% (CA 125 > 35 U ml-1), with a specificity of 71%. A correlation with the depth of myometrial infiltration was found for neither of the tumor markers under investigation. In addition, neither TATI nor CA 125 correlated well with tumor grade. The combination of TATI and CA 125 had a high positive predictive value (84%) when no other gynecologic pathologies were present. Furthermore, if TATI and CA 125 levels are within normal ranges and gynecological examination does not show other abnormalities besides vaginal bleeding, endometrial carcinoma appears to be very unlikely.
  
  
  CONCLUSIONS
  We concluded that, while TATI and CA 125 may not be recommended as a screening method for the detection of endometrial cancer, the combination of TATI and CA 125 is a valuable additional tool for further evaluation of women with suspected uterine cancer.
authors.affiliation: Department of Gynecology and Obstetrics, Lainz Medical Center, Vienna, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Peters-Engl
authors.forename: P
authors.initials: P
authors.lastname: Buxbaum
authors.forename: E
authors.initials: E
authors.lastname: Ogris
authors.forename: P
authors.initials: P
authors.lastname: Sevelda
authors.forename: M
authors.initials: M
authors.lastname: Medl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood*; D016889:Endometrial Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D004715:Endometriosis / Q000097:blood; D005260:Female; D005831:Genital Diseases, Female / Q000097:blood / Q000175:diagnosis; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011863:Radioimmunoassay; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014359:Trypsin Inhibitor, Kazal Pancreatic / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D014359:Trypsin Inhibitor, Kazal Pancreatic