Serum tumour associated trypsin inhibitor, as a biomarker for survival in renal cell carcinoma

Abstract

Objective

Tumour associated trypsin inhibitor (TATI) is a peptide that is a marker for several tumours. TATI may also behave as an acute phase reactant in severe inflammatory disease. Overexpression of TATI predicts an unfavourable outcome for many cancers. This study aimed to evaluate the prognostic value of pre- and postoperative concentration of TATI in serum (S-TATI) of patients with renal cell carcinoma (RCC).

Materials and methods

S-TATI was determined by time resolved immunofluorometric assay in preoperative and postoperative samples that were collected from 132 RCC patients, who underwent partial or complete nephrectomy in Helsinki University Hospital from May 2005 to July 2010.

Results

Preoperative S-TATI was significantly associated with tumour stage, lymph-node involvement, metastatic stage, Chronic Kidney Disease Stage (CKD grade), and preoperative C-reactive protein level (p < 0.05). Postoperative S-TATI was significantly associated only with CKD grade (p < 0.001). Multivariate Cox regression analysis of postoperative S-TATI, as a continuous variable, was an independent prognostic factor for overall survival (HR = 1.01, 95% CI = 1.00−1.01, p = 0.03) and cancer-specific survival (CSS) (HR = 1.01, 95% CI = 1.00−1.02, p = 0.004).

Conclusions

Our data suggest that elevated postoperative S-TATI may be associated with adverse prognosis in RCC patients.

Keywords:

• S-TATI
• SPINK1
• PSTI
• renal cell carcinoma
• survival

Acknowledgements

The authors would like to thank statisticians Taija Alatalo and Paula Bergman for their assistance in the statistical analyses.

Disclosure statement

Kilpeläinen and Visapää have no conflict of interest to declare. Tornberg declares unrestricted financial grants from the Finnish Urological Association and reimbursements from SwanMedica for attending a scientific meeting. Järvinen P. declares a fee from Elypta, outside the submitted work, Taari declares research funding from Medivation/Astellas/Pfizer, Orion and Myovant, outside the submitted work. Järvinen R. declares research funding from Photocure, Bristol Myers Squibb, Roche and Nektar, outside the submitted work. Nisen has received travel grants from Olympus, Novartis, Pfizer, Astellas-Pharma, consultation fees from Ipsen, Pfizer and a fee from Elypta, outside submitted work. U-H Stenman is the holder of a patent for TATI, which has expired.

Additional information

Funding

This study was financially supported by the Competitive State Research Financing of the Expert Responsibility area of Helsinki University Hospital and the first author received an unrestricted financial grant from Finnish Urological Association.