title: High tissue expression of tumour-associated trypsin inhibitor (TATI) associates with a more favourable prognosis in gastric cancer.
abstract: OBJECTIVE
  The tumour-associated trypsin inhibitor (TATI) is a 6-kDa protease inhibitor with potential inhibitory effects on tissue degradation. In serum, increased levels have been associated with adverse prognosis in different forms of cancer. We assessed the tumour tissue expression and prognostic value of TATI in a surgically treated, single-institution series of patients with gastric cancer.
  
  
  RESULTS
  Using a monoclonal anti-TATI antibody, immunohistochemistry was performed on formalin-fixed paraffin-embedded tumour specimens from 336 patients. TATI expression was observed in 265 (79%) of the tumours. There was a significant association between high TATI expression and low stage (P = 0.007), superficial tumours (P = 0.005), and absence of nodal (P = 0.015) and of distant metastases (P = 0.022). In univariate analysis, patients with high TATI expression had a significantly more favourable 5-year cumulative survival compared with patients with negative to moderate immunostaining (43% and 28%, respectively, P = 0.006). On multivariate survival analysis stratified for estimated cure of surgery, stage (P < 0.0001) and age (P = 0.022) at the time of surgery were independent prognostic factors.
  
  
  CONCLUSIONS
  High TATI expression in tumour tissue was detected more frequently in patients with early-stage gastric cancer and seems to correlate with a favourable outcome.
authors.affiliation: Department of Surgery, University of Helsinki, Helsinki, Finland.
authors.forename: J-P
authors.initials: JP
authors.lastname: Wiksten
authors.forename: J
authors.initials: J
authors.lastname: Lundin
authors.forename: S
authors.initials: S
authors.lastname: Nordling
authors.forename: A
authors.initials: A
authors.lastname: Kokkola
authors.forename: U-H
authors.initials: UH
authors.lastname: Stenman
authors.forename: C
authors.initials: C
authors.lastname: Haglund
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology*; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000378:metabolism / Q000473:pathology*; D016019:Survival Analysis; D014359:Trypsin Inhibitor, Kazal Pancreatic / Q000096:biosynthesis*
chemical_list: D014359:Trypsin Inhibitor, Kazal Pancreatic