Tumor-associated trypsin inhibitor in patients with endometrial cancer

Hepatitis B Virus X Protein-Induced Serine Protease Inhibitor Kazal Type 1 Is Associated with the Progression of HBV-Related Diseases

Objective

Hepatitis B virus (HBV) causes inflammation of the liver and is the leading cause of both liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Serine protease inhibitor Kazal type 1 (SPINK1) is an acute-phase response protein that is overexpressed in liver cancer tissue. This study investigated the clinical value of SPINK1 with regard to the diagnosis of HBV-related diseases and its regulatory mechanism.

Methods

Serum levels of SPINK1 in HBV-infected patients and healthy participants were detected by enzyme-linked immunosorbent assay (ELISA). Reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) and western blotting were used to detect differential expression of SPINK1 mRNA and protein in HepG2 and HepG2.2.15 cells. The HBV infectious clone pHBV1.3 and its individual genes were cotransfected into HepG2 cells with the SPINK1 promoter coupled to a luciferase reporter; luciferase activity was measured, and the expression levels of SPINK1 were examined.

Results

Serum SPINK1 levels of HBV-infected patients were significantly higher than those of healthy participants, and the serum levels of SPINK1 in patients who tested positive for HBeAg were significantly higher than those in patients who tested negative for HBeAg. The serum SPINK1 levels of patients with LC or HCC were markedly higher than those of patients with chronic hepatitis. The HBV X protein (HBx) activated the SPINK1 promoter to upregulate expression of SPINK1 at both mRNA and protein levels.

Conclusions

HBV enhances expression of SPINK1 through X. SPINK1 levels are increased during progression of HBV-related diseases and might be utilized as a biomarker for the diagnosis of HBV-related diseases.

Monitoring the treatment outcome in endometrial cancer patients by CEA and TATI

An attempt was made to compare the usefulness of determining markers carcinoembryonic antigen (CEA) and tumor-associated trypsin inhibitor (TATI) in endometrial cancer patients in whom recurrence or distant metastasis was diagnosed in observation after treatment. The study included 316 patients aged 32-81, average age of 61 years, SD = 8.72, with diagnosed endometrial cancer, treated between 1994 and 1995 at the Oncology Center in Warsaw and then under observation from 4 months to 17 years after completion of treatment. The levels of the markers TATI and CEA were assessed from the first five serum samples taken during postoperative radiotherapy and in the initial period of observation after completed treatment. Receiver operating characteristic (ROC) curves were generated, determining the sensitivity and specificity of both CEA and TATI in patients who experienced treatment failure, i.e., recurrence and distant metastasis. Assessing the sensitivity of the marker CEA, it was found that if in the third sample, i.e., during radiation therapy, the marker level increased by more than 20 % compared with the first sample, then recurrence of cancer occurred during the observation period in 75.9 % of patients and metastatic occurred in 69.7 % of patients. In the evaluation of the marker TATI, it was found that if the level of TATI between the first and the third sample increases by 10.6 % from the initial level, then in 84.4 % (sensitivity) of cases, this means the occurrence of cancer recurrence and in 75.7 % (sensitivity) of cases, the occurrence of metastasis. The specificity of both markers is low and not useful diagnostically.