Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland.
Oncology. 2012;82(4):234-41. doi: 10.1159/000336080. Epub 2012 Apr 12.
The tumour-associated trypsin inhibitor TATI is expressed together with trypsin in many cancer forms, and an elevated serum level associates with poor prognosis. TATI can reduce tissue destruction by inhibiting trypsin and other proteinases, and in some cancer forms, its high tissue expression is associated with favourable prognosis. We analyzed the prognostic values of TATI, trypsinogen-1 and trypsinogen-2 immunoexpression from tissue array blocks constructed from surgical specimens of 592 colorectal cancer patients.
TATI positivity correlated negatively with differentiation (p < 0.001) and positively with the histological type of adenocarcinoma (p < 0.001). Trypsinogen-1 and trypsinogen-2 positivity correlated with Dukes' stage (p = 0.045, p = 0.050); the percentage of trypsinogen-1- and trypsinogen-2-positive tumours was lower in metastasized (Dukes' stage C-D) than in local (Dukes' stage A-B) disease. In addition, trypsinogen-2 correlated inversely with differentiation (p = 0.012). In univariate analysis, the expression of TATI associated with more favourable cancer-specific survival (p = 0.010). In multivariate analysis, low TATI (p = 0.044), age (p < 0.001), Dukes' stage (p < 0.001), tumour differentiation (p = 0.020) and location in the rectum (p = 0.006) were independent prognostic factors for adverse outcome. Furthermore, TATI expression was an independent prognostic factor in a subgroup of trypsinogen-1- (p = 0.007) and trypsinogen-2-positive (p = 0.006) tumours.
TATI tissue expression is an independent prognostic marker in colorectal cancer.
肿瘤相关胰蛋白酶抑制剂 TATI 与多种癌症形式中的胰蛋白酶一起表达，血清水平升高与预后不良相关。TATI 可通过抑制胰蛋白酶和其他蛋白酶来减少组织破坏，在某些癌症形式中，其高组织表达与良好的预后相关。我们分析了来自 592 例结直肠癌患者手术标本构建的组织阵列块中 TATI、胰蛋白酶原-1 和胰蛋白酶原-2 免疫表达的预后价值。
TATI 阳性与分化呈负相关（p<0.001），与腺癌组织类型呈正相关（p<0.001）。胰蛋白酶原-1 和胰蛋白酶原-2 阳性与 Dukes 分期相关（p=0.045，p=0.050）；转移（Dukes'分期 C-D）的肿瘤中胰蛋白酶原-1 和胰蛋白酶原-2 阳性的比例低于局部（Dukes'分期 A-B）疾病。此外，胰蛋白酶原-2 与分化呈负相关（p=0.012）。在单因素分析中，TATI 的表达与更有利的癌症特异性生存相关（p=0.010）。在多因素分析中，低 TATI（p=0.044）、年龄（p<0.001）、Dukes 分期（p<0.001）、肿瘤分化（p=0.020）和直肠位置（p=0.006）是不良预后的独立预后因素。此外，TATI 表达是胰蛋白酶原-1 阳性（p=0.007）和胰蛋白酶原-2 阳性（p=0.006）肿瘤的独立预后因素。
TATI 组织表达是结直肠癌的独立预后标志物。
