Clinical Significance
Tumor Associated Trypsin Inhibitor (TATI) has been used as a marker of mucinous ovarian carcinoma, urothelial carcinoma and renal cell carcinoma. TATI is metabolised by the kidneys and is thus elevated in patients with renal failure. It may be elevated in nonneoplastic processes such as pancreatitis and can be used as a prognostic marker in this setting (levels above 70 micrograms/L are associated with poor prognosis).
50% of stage I mucinous ovarian carcinomas are associated with elevated TATI and nearly 100% of stave IV tumors show elevated TATI.
85-95% of pancreatic adenocarcinomas are associated with increased TATI (but elevation in pancreatitis limits the clinical utility of TATI in this setting- see above).
60% of gastric adenocarcinomas show elevated TATI, particularly tumors of diffusely infiltrative/signet ring type. TATI thus complements CEA which is elevated exclusively in intestinal type adenocarcinoma of the stomach.
In urothelial carcinoma, TATI expression varies with stage: ranging from 20% in low-stage tumors to 80% of high-stage tumors.
TATI sensitivity in the setting of renal cell carcinoma is approximately 70%. Elevated TATI is more likely to be see in patients with advanced-stage disease.
In nearly all tumor types studied, TATI is a marker of poor prognosis.
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“The hysterical find too much significance in things. The depressed find too little.”
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