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Rotterova P, Alaghehbandan R, Skopal J, Rogala J, Slisarenko M, Strakova Peterikova A, Michalova K, Montiel DP, Farcas M, Ulamec M, Stransky P, Fiala O, Pitra T, Hora M, Michal M, Pivovarcikova K, Hes O. Alpha-methyl CoA racemase ( AMACR) reactivity across the spectrum of clear cell renal cell neoplasms. Ann Diagn Pathol 2024; 71:152297. [PMID: 38579443 DOI: 10.1016/j.anndiagpath.2024.152297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/07/2024]
Abstract
a-Methylacyl coenzyme A racemase (AMACR) is traditionally considered to be a marker of papillary renal cell carcinoma. However, AMACR expression can be seen in other renal tumors. The aim of this study was to investigate AMACR immunoreactivity within the spectrum of clear cell renal cell neoplasms. Fifty-three clear cell renal epithelial tumors were used in assembling the following four cohorts: low grade (LG) clear cell renal cell carcinoma (CCRCC), high grade (HG) CCRCC, CCRCC with cystic changes, and multilocular cystic renal neoplasm of low malignant potential (MCRNLMP). Representative blocks were stained for AMACR, using two different clones (SP52 and OV-TL12/30). There were at least some AMACR immunoreactivity in 77.8 % and 68.9 % of CCRCCs (using SP52 and OV-TL12/30 clone, respectively). Moderate to strong positivity, or positivity in more than one third of the tumor (even weak in intensity) was detected in 46.7 % of CCRCCs using SP52 and in 48.9 % of CCRCC using OV-TL12/30 clone. The highest AMACR reactivity was observed in HG CCRCC (60 % by SP52 and 66.7 % by OV-TL12/30). Strong and diffuse AMACR positivity was detected in 8.9 % of all CCRCCs. AMACR immunoreactivity in MCRNLMP was 37.5 % (SP52 clone) and 25 % (OV-TL12/30 clone). We demonstrated relatively high expression rate of AMACR in CCRCC, while very variable in intensity and distribution. This finding may have diagnostic implications especially in limited samples (i.e., core biopsies), as AMACR positivity does not exclude the diagnosis of CCRCC.
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Affiliation(s)
- Pavla Rotterova
- Department of Pathology, Biopticka laborator, Pilsen, Czech Republic
| | - Reza Alaghehbandan
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Josef Skopal
- Department of Pathology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Joanna Rogala
- Department of Pathology, University Hospital Wroclaw, Poland
| | - Maryna Slisarenko
- Department of Pathology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic; Department of Pathology, CSD LAB, Kyiv, Ukraine
| | - Andrea Strakova Peterikova
- Department of Pathology, Biopticka laborator, Pilsen, Czech Republic; Department of Pathology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Kvetoslava Michalova
- Department of Pathology, Biopticka laborator, Pilsen, Czech Republic; Department of Pathology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Delia Perez Montiel
- Department of Pathology, Institute Nacional de Cancerologia, Mexico City, Mexico
| | - Mihaela Farcas
- Department of Pathology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic; Onco Team Diagnostic, București, Romania
| | - Monika Ulamec
- Department of Pathology and Cytology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Petr Stransky
- Department of Urology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Ondrej Fiala
- Department of Oncology and Radiotherapeutics, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic; Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Tomas Pitra
- Department of Urology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Milan Hora
- Department of Urology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Michal Michal
- Department of Pathology, Biopticka laborator, Pilsen, Czech Republic; Department of Pathology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Kristyna Pivovarcikova
- Department of Pathology, Biopticka laborator, Pilsen, Czech Republic; Department of Pathology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
| | - Ondrej Hes
- Department of Pathology, Biopticka laborator, Pilsen, Czech Republic; Department of Pathology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic
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Samir Sayed RM, El Shorbagy G, Shibel PEE. Immunohistochemical Expression of Alpha-Methyl-Coa ( AMACR) and ERG in Prostatic Adenocarcinoma and Prostatic Hyperplasia: A Comparative Study. Asian Pac J Cancer Prev 2023; 24:2861-2868. [PMID: 37642075 PMCID: PMC10685206 DOI: 10.31557/apjcp.2023.24.8.2861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE This observational comparative study aimed at investigating the diagnostic accuracy of ERG in differentiating benign and malignant prostatic lesions and comparing it to the diagnostic accuracy of AMACR. We also aimed at comparing AMACR and ERG expression to Gleason grade of the carcinoma cases. METHODS Seventy- two cases (22 prostatic hyperplasia and 50 prostatic carcinoma) were collected from the pathology department at Cairo university. The cases were immunostained by antibodies against AMACR and ERG. Immunohistochemical expressions of both markers were differentially examined in benign and malignant cases, compared to each other's, as well as, to the grade group of the malignant cases. RESULTS AMACR showed 62% sensitivity and 86.4% specificity for the diagnosis of PC, with a statistically significant differential expression in benign and malignant lesions (P=0.001). Its expression also correlated significantly with the age (p=0.007), Gleason grade (P=0.006) and perineural invasion (P=0.011). Although ERG showed 100% specificity to PC with no expression in hyperplasia cases, it showed only 22% sensitivity for PC cases. ERG expression also showed statistically significant correlation with the Gleason grade. No association between ERG and AMACR expression was detected in our study (P=0.151). Regarding the diagnostic accuracy, although ERG accuracy was much lower than that of AMACR, combining both markers yielded a higher diagnostic accuracy. CONCLUSION Although ERG proved no superior value than AMACR in diagnosing prostatic lesions, combining both markers may lead to higher diagnostic accuracy owing to higher ERG specificity for PC.
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Affiliation(s)
| | - Galal El Shorbagy
- Department of Urology, Faculty of medicine, Cairo University, Egypt.
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Kiełb P, Kowalczyk K, Gurwin A, Nowak Ł, Krajewski W, Sosnowski R, Szydełko T, Małkiewicz B. Novel Histopathological Biomarkers in Prostate Cancer: Implications and Perspectives. Biomedicines 2023; 11:1552. [PMID: 37371647 DOI: 10.3390/biomedicines11061552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/12/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Prostate cancer (PCa) is the second most frequently diagnosed cancer in men. Despite the significant progress in cancer diagnosis and treatment over the last few years, the approach to disease detection and therapy still does not include histopathological biomarkers. The dissemination of PCa is strictly related to the creation of a premetastatic niche, which can be detected by altered levels of specific biomarkers. To date, the risk factors for biochemical recurrence include lymph node status, prostate-specific antigen (PSA), PSA density (PSAD), body mass index (BMI), pathological Gleason score, seminal vesicle invasion, extraprostatic extension, and intraductal carcinoma. In the future, biomarkers might represent another prognostic factor, as discussed in many studies. In this review, we focus on histopathological biomarkers (particularly CD169 macrophages, neuropilin-1, cofilin-1, interleukin-17, signal transducer and activator of transcription protein 3 (STAT3), LIM domain kinase 1 (LIMK1), CD15, AMACR, prostate-specific membrane antigen (PSMA), Appl1, Sortilin, Syndecan-1, and p63) and their potential application in decision making regarding the prognosis and treatment of PCa patients. We refer to studies that found a correlation between the levels of biomarkers and tumor characteristics as well as clinical outcomes. We also hypothesize about the potential use of histopathological markers as a target for novel immunotherapeutic drugs or targeted radionuclide therapy, which may be used as adjuvant therapy in the future.
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Affiliation(s)
- Paweł Kiełb
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wrocław Medical University, 50-556 Wroclaw, Poland
| | - Kamil Kowalczyk
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wrocław Medical University, 50-556 Wroclaw, Poland
| | - Adam Gurwin
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wrocław Medical University, 50-556 Wroclaw, Poland
| | - Łukasz Nowak
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wrocław Medical University, 50-556 Wroclaw, Poland
| | - Wojciech Krajewski
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wrocław Medical University, 50-556 Wroclaw, Poland
| | - Roman Sosnowski
- Department of Urogenital Cancer, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Tomasz Szydełko
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wrocław Medical University, 50-556 Wroclaw, Poland
| | - Bartosz Małkiewicz
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wrocław Medical University, 50-556 Wroclaw, Poland
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Nili F, Fathi S, Tavakoli M, Mirzaian E, Lotfi M. Diagnostic Accuracy of Alpha-Methylacyl-CoA Racemase Immunohistochemical Expression for the Diagnosis of Ovarian and Endometrial Clear Cell Carcinomas. Iran J Pathol 2023; 18:57-63. [PMID: 37383161 PMCID: PMC10293609 DOI: 10.30699/ijp.2023.556417.2925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/16/2022] [Indexed: 06/30/2023]
Abstract
Background & Objective Clear cell carcinoma (CCC) is an uncommon histopathologic subtype of ovarian and endometrial carcinoma. Due to the morphologic overlapping with other subtypes of ovarian and endometrial carcinomas, an accurate diagnosis is crucial. Methods In this study, 31 cases of ovarian clear cell carcinoma (OCCC), 28 endometrial clear cell carcinoma (ECCC), and 80 non-CCC subtypes (33 high-grade serous carcinomas of the ovary, 2 low-grade serous carcinomas, 10 ovarian endometrioid, 3 serous carcinomas and 29 endometrioid carcinomas of the endometrium) were investigated for immunohistochemical expression of AMACR. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the distinction of OCCC and ECCC from other histopathologic subtypes were calculated. Results Positive AMACR staining was seen in 18 OCCCs (58%) and 10 ECCCs (35.7%). In the non-clear cell group, 44 cases of ovarian (98%) and 25 cases of endometrial carcinoma (78%) showed negative results. Only one case of ovarian endometrioid carcinoma and 7 cases (22%) of endometrial endometrioid carcinomas revealed a positive reaction (P<0.05). Collectively, sensitivity, specificity, PPV, and NPV of AMACR expression, for the diagnosis of OCCC were calculated as 58%, 98%, 94.7%, and 77.2%, respectively. The sensitivity, specificity, PPV, and NPV were shown to be as 35.7%, 78.1%, 58.8%, and 58.1%, respectively in the endometrium. Conclusion AMACR may be a highly specific immunohistochemical marker for the distinction of serous and clear cell carcinoma. A small percentage of endometrioid carcinoma may show positive staining. The sensitivity of this marker may not be higher than the other well-known Napsin-A IHC marker.
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Affiliation(s)
- Fatemeh Nili
- Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheib Fathi
- Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansoureh Tavakoli
- Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Mirzaian
- Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Lotfi
- Department of Pathology, Amir-Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Lerner G, Tang H, Singh K, Golestani R, St Claire S, Humphrey PA, Lannin D, Janostiak R, Harigopal M. AMACR Expression is a Potential Diagnostic Marker in Apocrine Lesions of Breast, and is Associated with High Histologic Grade and Lymph Node Metastases in Some Invasive Apocrine Breast Cancers. Clin Breast Cancer 2023; 23:199-210. [PMID: 36577560 DOI: 10.1016/j.clbc.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/15/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Carcinoma with apocrine differentiation (AC) is a subtype of breast carcinoma with apocrine features in >90% of the tumor. Molecular studies demonstrate AC has high expression of androgen receptor (AR) mRNA. Pure AC lack estrogen receptor (ER), progesterone receptor (PR), and express AR, with variable human epidermal growth factor 2 (HER2) status. Currently, in triple negative AC, no targetable therapies or specific diagnostic markers exist. MATERIALS AND METHODS α-Methylacyl CoA racemase (AMACR) expression was investigated as a marker of apocrine differentiation using a single-plex immunoperoxidase stain, and a novel AMACR/p63 dual stain in a subset of cases, across 1) benign apocrine lesions (apocrine metaplasia, adenosis) 2) apocrine DCIS (ADCIS), 3) AC/ invasive ductal carcinoma (IDC) with apocrine features, 4) non-apocrine triple negative breast cancer (TNBC) and 5) IDC, no special type. A sub-set of cases were evaluated by tissue microarray. RESULTS AMACR expression was increased in both AC and ADCIS, with minimal expression in benign breast tissue, TNBC and IDC, NST cases. In invasive cases, those with positive AMACR (>5% positivity) were significantly associated with higher histologic grade (P = .006), initial N stage (chi squared 0.044), and lack of ER or PR expression (both P < .001), with no correlation with overall survival. Analysis of TCGA breast cancer datasets revealed AMACR expression was significantly higher in molecularly defined apocrine carcinomas relative to basal and luminal subtypes. Moreover, high AMACR expression predicted worse relapse-free and distant-metastasis free survival, among both ER-/PR-/Her2- and ER-/PR-/Her2+ breast cancer cohorts (log-rank P = .081 and .00011, respectively). CONCLUSION AMACR represents a promising diagnostic and prognostic marker in apocrine breast lesions. Further study is needed to determine the biologic and clinical significance of this protein in AC.
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Affiliation(s)
- Gabriel Lerner
- Department of Surgical Pathology, Yale University School of Medicine, New Haven, CT
| | - Haiming Tang
- Department of Surgical Pathology, Yale University School of Medicine, New Haven, CT
| | - Kamaljeet Singh
- Department of Pathology and Laboratory Medicine, Alpert Medical School of Brown University, Providence, RI
| | - Reza Golestani
- Department of Surgical Pathology, Yale University School of Medicine, New Haven, CT
| | - Samantha St Claire
- Yale Pathology Tissue Services, Yale University School of Medicine, New Haven, CT
| | - Peter A Humphrey
- Department of Surgical Pathology, Yale University School of Medicine, New Haven, CT
| | - Donald Lannin
- Department of Surgery, Section of Surgical Oncology, Yale University School of Medicine, New Haven, CT
| | | | - Malini Harigopal
- Department of Surgical Pathology, Yale University School of Medicine, New Haven, CT
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Gatalica Z, Stafford P, Vranic S. Alpha-methylacyl-CoA racemase ( AMACR) protein is upregulated in early proliferative lesions of the breast irrespective of apocrine differentiation. Hum Pathol 2022; 129:40-46. [PMID: 35998819 DOI: 10.1016/j.humpath.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 12/14/2022]
Abstract
Alpha-methylacyl-CoA racemase (AMACR/P504S) is a mitochondrial and peroxisomal enzyme involved in the branched-chain fatty acid and bile acid metabolism. AMACR is a useful diagnostic biomarker for prostate carcinomas and several other malignancies. Its expression in apocrine breast lesions had been previously reported, but its role in breast cancer progression has not been fully investigated. One hundred fifty breast samples (80 with invasive carcinomas) were studied. The expression of AMACR protein was analyzed using the immunohistochemical method (IHC). Lesions were considered positive if AMACR was detected in ≥10% of the cells at any intensity comprising a histologically defined normal epithelial structure or a pathologic lesion. In addition, AMACR mRNA relative expression was calculated from the whole-transcript RNA-Seq performed on >20,000 diverse tumor samples using a 20,000+ hybrid-capture NGS assay with the transcript capture panel based on the Agilent SureSelect Human All ExonV7. Expression of AMACR protein was restricted to epithelia. It was uncommon in the normal breast (7/81 samples, 9%). Increasing AMACR expression was observed with proliferative epithelial lesions (18% of usual ductal hyperplasias/adenosis, 70% of atypical lesions and 72% of DCIS/LCIS). Invasive ductal carcinomas NST and invasive lobular carcinomas expressed AMACR in 64% and 46%, respectively. The highest AMACR expression was observed in luminal B and HER2-positive breast carcinomas (86-100%). Triple-negative breast carcinomas exhibited AMACR in 50% of the cases. Apocrine lesions showed strong, nearly uniform overexpression of AMACR (100% of metaplasias, hyperplasias and in situ carcinomas and 88% of invasive apocrine carcinomas were positive). RNA-Seq analysis also confirmed AMACR expression in breast carcinomas, although its median value was substantially lower with a lower standard deviation than in prostate carcinomas. Over-expression of AMACR characterizes various proliferative, preinvasive and invasive breast lesions and is not specific to the apocrine morphology. It points to altered lipid metabolism (branched fatty acids) as one of the general characteristics of breast carcinogenesis, like several other malignancies. Its early detection may represent a potential target for cancer progression intervention.
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Affiliation(s)
- Zoran Gatalica
- Department of Pathology, University of Oklahoma College of Medicine, Oklahoma City, OK 73104, United States
| | | | - Semir Vranic
- College of Medicine, QU Health, Qatar University, Doha, 2713, Qatar.
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Stephen N, Badhe BA. Diagnostic utility of immunohistochemical markers alpha methyl acyl coA racemase ( AMACR) and Ets related gene (ERG) in prostate cancer. Int J Clin Exp Pathol 2022; 15:364-372. [PMID: 36237639 PMCID: PMC9547992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 06/21/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To study the sensitivity and specificity of IHC markers AMACR and ERG in prostatic adenocarcinoma. METHODS The study was a prospective one and samples were collected from August 2014 to June 2016. A total of 186 samples were obtained from the Department of Urology, in which 112 of these were benign prostatic hyperplasia (BPH), and 71 were prostatic adenocarcinoma. The adenocarcinoma cases were evaluated by two histopathologists, and appropriate Gleason score was given according to the modified ISUP Gleason grading system (2016). IHC markers AMACR & ERG were performed on the adenocarcinoma cases and their sensitivity and specificity were calculated. RESULTS AMACR was a highly sensitive and specific marker for detecting prostatic carcinoma with a sensitivity and specificity of 95.8% and 96.5% respectively. ERG was a very specific marker with poor sensitivity in detecting prostate cancer. The sensitivity and specificity of ERG were 35.2% and 100% respectively. ERG expression decreased with increasing Gleason grade, PSA level, and tumour volume, which was statistically significant while the association of AMACR with Gleason grade or with tumor volume was not significant. CONCLUSION ERG is a marker of early prostatic carcinogenesis and tumors may be positive or negative subtypes. Special histomorphologic features like perineural invasion, glomerulations, and intraluminal blue mucin were also studied. AMACR was a highly sensitive marker for detecting prostatic adenocarcinoma, while ERG was highly specific.
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Affiliation(s)
- Norton Stephen
- Department of Pathology, Dhanvantri Nagar, Gorimedu, Puducherry 605 006, JIPMER India
| | - Bhawana A Badhe
- Department of Pathology, Dhanvantri Nagar, Gorimedu, Puducherry 605 006, JIPMER India
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Fu P, Bu C, Cui B, Li N, Wu J. Screening of differentially expressed genes and identification of AMACR as a prognostic marker in prostate cancer. Andrologia 2021; 53:e14067. [PMID: 33861880 DOI: 10.1111/and.14067] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 02/01/2021] [Accepted: 03/23/2021] [Indexed: 12/27/2022] Open
Abstract
Prostate cancer, the second most common cancer found in male over the world, was estimated to have 191,930 new cases and 33,330 deaths in 2020 in the United States. Prostate cancer is very common in male, about 12.1% of men will acquire this cancer in their lifetime, and a higher risk was reported in older men and African American men. Gene deregulations have been found to be extensively associated with cancer development. To gain further insight into how gene deregulation affects prostate cancer, we analysed three gene profiling datasets of prostate cancer from Gene Expression Omnibus (GEO) applying bioinformatic tools in our study. Firstly, we identified common differently expressed genes (DEGs) shared by the three gene profiling datasets, constructed protein-protein interaction network and determined top 10 hub genes. Further DEGs validation in TCGA and Human Protein Atlas Database identified AMACR as the core gene. We then analysed the role of AMACR in prostate cancer cell lines and found that AMACR-knockdown resulted in the decreased cell proliferation and increased apoptosis. These results suggest an oncogenic role of AMACR in prostate cancer, and it could be a potential biomarker for the diagnosis of prostate cancer.
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Affiliation(s)
- Ping Fu
- Department of Oncology, People's Hospital of Zhangqiu District, Jinan City, China
| | - Chunying Bu
- Department of Internal Medicine, People's Hospital of Zhangqiu District, Jinan City, China
| | - Bin Cui
- Department of Oncology, People's Hospital of Zhangqiu District, Jinan City, China
| | - Na Li
- Department of Internal Medicine Nursing, People's Hospital of Zhangqiu District, Jinan City, China
| | - Jifeng Wu
- Department of Oncology, People's Hospital of Zhangqiu District, Jinan City, China
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Lindner V, Waydelich A, Chen CC, Jones C, Stratton SP. Performance comparison of anti-p504s (SP116) Rabbit Monoclonal Primary Antibody vs. Monoclonal Rabbit Anti-Human AMACR clone 13H4 when duplexed with VENTANA Basal Cell Cocktail (34βE12+p63) as a diagnostic aid for prostatic adenocarcinoma using immunohistochemistry. Virchows Arch 2021; 479:337-343. [PMID: 33811532 DOI: 10.1007/s00428-021-03088-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 12/24/2022]
Abstract
Alpha-methylacyl-coenzyme A-racemase (AMACR), also known as p504s, is overexpressed in prostatic adenocarcinoma and is frequently used in combination with basal cell markers to aid in diagnosing difficult prostate adenocarcinoma cases. In this retrospective method comparison study, we examined the sensitivity and specificity of the ready-to-use anti-p504s (SP116) Rabbit Monoclonal Primary Antibody compared to the monoclonal rabbit anti-human AMACR clone 13H4 in prostatic adenocarcinoma samples. De-identified prostatic adenocarcinoma tissue samples were stained with either the SP116 or 13H4 antibody clone in combination with the VENTANA Basal Cell Cocktail (34βE12+p63) and scored as positive or negative for prostatic adenocarcinoma. The scoring pathologist was blinded to the known historical diagnosis of each sample. The scoring pathologist correctly diagnosed each sample regardless of which p504s clone was used. Both assays using either clone were 100% concordant in their sensitivity and specificity. This study demonstrates that the ready-to-use anti-p504s (SP116) Rabbit Monoclonal Primary Antibody is equivalent to clone 13H4 concentrate when used according to package insert instructions in combination with the VENTANA Basal Cell Cocktail (34βE12+p63) to aid pathologists in the diagnosis of prostatic adenocarcinoma.
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Affiliation(s)
- Veronique Lindner
- Departement de Pathologie, Les Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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Kong G, Lee H, Tran Q, Kim C, Park J, Kwon SH, Kim SH, Park J. Corrigendum: Current Knowledge on the Function of α-Methyl Acyl-CoA Racemase in Human Diseases. Front Mol Biosci 2021; 8:639164. [PMID: 33842543 PMCID: PMC8029588 DOI: 10.3389/fmolb.2021.639164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/22/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gyeyeong Kong
- Department of Pharmacology, College of Medicine, Chungnam National University, Daejeon, South Korea.,Department of Medical Science, Metabolic Syndrome and Cell Signaling Laboratory, Institute for Cancer Research, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Hyunji Lee
- Department of Pharmacology, College of Medicine, Chungnam National University, Daejeon, South Korea.,Department of Medical Science, Metabolic Syndrome and Cell Signaling Laboratory, Institute for Cancer Research, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Quangdon Tran
- Department of Pharmacology, College of Medicine, Chungnam National University, Daejeon, South Korea.,Department of Medical Science, Metabolic Syndrome and Cell Signaling Laboratory, Institute for Cancer Research, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Chaeyeong Kim
- Department of Pharmacology, College of Medicine, Chungnam National University, Daejeon, South Korea.,Department of Medical Science, Metabolic Syndrome and Cell Signaling Laboratory, Institute for Cancer Research, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Jisoo Park
- Department of Pharmacology, College of Medicine, Chungnam National University, Daejeon, South Korea.,Department of Medical Science, Metabolic Syndrome and Cell Signaling Laboratory, Institute for Cancer Research, College of Medicine, Chungnam National University, Daejeon, South Korea.,Department of Life Science, Hyehwa Liberal Arts College, LINC Plus Project Group, Daejeon University, Daejeon, South Korea
| | - So Hee Kwon
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, South Korea
| | - Seon-Hwan Kim
- Department of Neurosurgery, Institute for Cancer Research, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Jongsun Park
- Department of Pharmacology, College of Medicine, Chungnam National University, Daejeon, South Korea.,Department of Medical Science, Metabolic Syndrome and Cell Signaling Laboratory, Institute for Cancer Research, College of Medicine, Chungnam National University, Daejeon, South Korea
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Gülhan Ö, Mahi B. The Role of AMACR, CD10, TMPRSS2-ERG, and p27 Protein Expression Among Different Gleason Grades of Prostatic Adenocarcinoma on Needle Biopsy. Clin Med Insights Oncol 2020; 14:1179554920947322. [PMID: 35185351 PMCID: PMC8855389 DOI: 10.1177/1179554920947322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/06/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE We examined the immunohistochemical expression of α-methyl acyl coenzyme A racemase (AMACR), CD10, TMPRSS2-ERG, and p27 in prostate adenocarcinoma tumors with different Gleason growth patterns and nonneoplastic prostate tissues to elucidate their roles in prostate carcinogenesis and histological aggressiveness. MATERIAL AND METHODS In total, 80 archival core biopsy tissues diagnosed as prostate carcinoma, benign prostate hyperplasia, and atrophy cases were included. Immunoreactivity was evaluated by calculating the percentage of positively stained cells and the staining intensity. The mean values and test of significance were obtained using the Kruskal-Wallis test. RESULTS We obtained mostly intense immunoreactivity for AMACR, CD10, and ERG in adenocarcinomas. Although no significant differences were noted regarding AMACR and ERG expression, samples with Gleason growth patterns 3 and 5 tended to be strongly positive for ERG. Pattern 3 tumors exhibited the weakest positivity for CD10. The p27 expression was strong and diffuse in nonneoplastic prostate tissues. The loss of p27 expression was more frequent for pattern 5 tumors. CONCLUSION ERG and AMACR were powerful markers to detect cancer. Especially, ERG is evident in early tumors may reflect its interaction with functional androgen receptors in cancer initiation. Pattern 5 tumors associated with stroma may have been exposed to more stromal substrates and upregulate their CD10 content as a protein degrader. We suggest that CD10 expression is associated with an increasing tumor grade. Decreased concentrations of p27 protein might be implicated in prostate carcinogenesis and may be a useful immunohistochemical adjunct in predicting histological aggressiveness.
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Affiliation(s)
- Özdemir Gülhan
- Department of Pathology, Mengücek Gazi Training and Research Hospital, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Balcı Mahi
- Department of Pathology, Faculty of Medicine, Kirikkale University, Kırıkkale, Turkey
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Yoshizawa A, Takahara K, Saruta M, Zennami K, Nukaya T, Fukaya K, Ichino M, Fukami N, Niimi A, Sasaki H, Kusaka M, Suzuki M, Sumitomo M, Shiroki R. Combined α-methylacyl-CoA racemase inhibition and docetaxel treatment reduce cell proliferation and decrease expression of heat shock protein 27 in androgen receptor-variant-7-positive prostate cancer cells. Prostate Int 2020; 9:18-24. [PMID: 33912510 PMCID: PMC8053692 DOI: 10.1016/j.prnil.2020.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/19/2020] [Accepted: 07/03/2020] [Indexed: 12/24/2022] Open
Abstract
Background Disease progression in castrate-resistant prostate cancer (PCa) is most commonly driven by the reactivation of androgen receptor (AR) signaling and involves AR splice variants including ARV7. Materials and methods We used the ARV7-positive PCa cell line, 22Rv1, to study the relationship of the PCa marker α-methylacyl-CoA racemase (AMACR), AR, and ARV7 in PCa. Results Docetaxel addition but not AMACR inhibition decreased the proliferation of 22Rv1 cells. The combination of AMACR inhibition and docetaxel treatment resulted in a maximum reduction of cell proliferation. The Western blotting analysis revealed that both AR and ARV7 expression were significantly decreased with the use of charcoal-stripped serum following AMACR inhibition and docetaxel treatment. AMACR inhibition and docetaxel treatment in the charcoal-stripped serum condition reduced the proliferation of 22Rv1, possibly via the downregulation of the heat shock protein 27. Conclusion Using cell proliferation and Western blot analysis, we demonstrated that AMACR inhibition and docetaxel treatment, under androgen deprivation conditions, significantly reduced the proliferation of ARV7 positive cancer cells and decreased the levels of AR and ARV7 expression, possibly via downregulation of heat shock protein 27.
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Affiliation(s)
- Atsuhiko Yoshizawa
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Kiyoshi Takahara
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- Corresponding author. Department of Urology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoake, Aichi, 470-1192 Japan
| | - Masanobu Saruta
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Kenji Zennami
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Takuhisa Nukaya
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Kosuke Fukaya
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Manabu Ichino
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Naohiko Fukami
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Atsuko Niimi
- Department of Molecular Oncology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Hitomi Sasaki
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Mamoru Kusaka
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Motoshi Suzuki
- Department of Molecular Oncology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Makoto Sumitomo
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Ryoichi Shiroki
- Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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Kong G, Lee H, Tran Q, Kim C, Park J, Kwon SH, Kim SH, Park J. Current Knowledge on the Function of α-Methyl Acyl-CoA Racemase in Human Diseases. Front Mol Biosci 2020; 7:153. [PMID: 32760737 PMCID: PMC7372137 DOI: 10.3389/fmolb.2020.00153] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 06/18/2020] [Indexed: 01/22/2023] Open
Abstract
Branched chain fatty acids perform very important functions in human diet and drug metabolism. they cannot be metabolized in mitochondria and are instead processed and degraded in peroxisomes due to the presence of methyl groups on the carbon chains. Oxidative degradation pathways for lipids include α- and β-oxidation and several pathways. In all metabolic pathways, α-methyl acyl-CoA racemase (AMACR) plays an essential role by regulating the metabolism of lipids and drugs. AMACR regulates β-oxidation of branched chain lipids in peroxisomes and mitochondria and promotes chiral reversal of 2-methyl acids. AMACR defects cause sensory-motor neuronal and liver abnormalities in humans. These phenotypes are inherited and are caused by mutations in AMACR. In addition, AMACR has been found to be overexpressed in prostate cancer. In addition, the protein levels of AMACR have increased significantly in many types of cancer. Therefore, AMACR may be an important marker in tumors. In this review, a comprehensive overview of AMACR studies in human disease will be described.
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Affiliation(s)
- Gyeyeong Kong
- Department of Pharmacology, College of Medicine, Chungnam National University, Daejeon, South Korea
- Department of Medical Science, Metabolic Syndrome and Cell Signaling Laboratory, Institute for Cancer Research, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Hyunji Lee
- Department of Pharmacology, College of Medicine, Chungnam National University, Daejeon, South Korea
- Department of Medical Science, Metabolic Syndrome and Cell Signaling Laboratory, Institute for Cancer Research, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Quangdon Tran
- Department of Pharmacology, College of Medicine, Chungnam National University, Daejeon, South Korea
- Department of Medical Science, Metabolic Syndrome and Cell Signaling Laboratory, Institute for Cancer Research, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Chaeyeong Kim
- Department of Pharmacology, College of Medicine, Chungnam National University, Daejeon, South Korea
- Department of Medical Science, Metabolic Syndrome and Cell Signaling Laboratory, Institute for Cancer Research, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Jisoo Park
- Department of Pharmacology, College of Medicine, Chungnam National University, Daejeon, South Korea
- Department of Medical Science, Metabolic Syndrome and Cell Signaling Laboratory, Institute for Cancer Research, College of Medicine, Chungnam National University, Daejeon, South Korea
- Department of Life Science, Hyehwa Liberal Arts College, LINC Plus Project Group, Daejeon University, Daejeon, South Korea
| | - So Hee Kwon
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, South Korea
| | - Seon-Hwan Kim
- Department of Neurosurgery, Institute for Cancer Research, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Jongsun Park
- Department of Pharmacology, College of Medicine, Chungnam National University, Daejeon, South Korea
- Department of Medical Science, Metabolic Syndrome and Cell Signaling Laboratory, Institute for Cancer Research, College of Medicine, Chungnam National University, Daejeon, South Korea
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Huskova Z, Knillova J, Kolar Z, Vrbkova J, Kral M, Bouchal J. The Percentage of Free PSA and Urinary Markers Distinguish Prostate Cancer from Benign Hyperplasia and Contribute to a More Accurate Indication for Prostate Biopsy. Biomedicines 2020; 8:biomedicines8060173. [PMID: 32630458 PMCID: PMC7344460 DOI: 10.3390/biomedicines8060173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/15/2020] [Accepted: 06/23/2020] [Indexed: 01/05/2023] Open
Abstract
The main advantage of urinary biomarkers is their noninvasive character and the ability to detect multifocal prostate cancer (CaP). We have previously implemented a quadruplex assay of urinary markers into clinical practice (PCA3, AMACR, TRPM8 and MSMB with KLK3 normalization). In this study, we aimed to validate it in a larger cohort with serum PSA 2.5-10 ng/mL and test other selected transcripts and clinical parameters, including the percentage of free prostate-specific antigen (PSA) (% free PSA) and inflammation. In the main cohort of 299 men, we tested the quadruplex transcripts. In a subset of 146 men, we analyzed additional transcripts (CD45, EPCAM, EZH2, Ki67, PA2G4, PSGR, RHOA and TBP). After a prostate massage, the urine was collected, RNA isolated from a cell sediment and qRT-PCR performed. Ct values of KLK3 (i.e., PSA) were strongly correlated with Ct values of other genes which play a role in CaP (i.e., PCA3, AMACR, TRPM8, MSMB and PSGR). AMACR, PCA3, TRPM8 and EZH2 mRNA expression, as well as % free PSA, were significantly different for BPH and CaP. The best combined model (% free PSA plus PCA3 and AMACR) achieved an AUC of 0.728 in the main cohort. In the subset of patients, the best AUC 0.753 was achieved for the combination of PCA3, % free PSA, EPCAM and PSGR. PCA3 mRNA was increased in patients with inflammation, however, this did not affect the stratification of patients indicated for prostate biopsy. In conclusion, the percentage of free PSA and urinary markers contribute to a more accurate indication for prostate biopsy.
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Affiliation(s)
- Zlata Huskova
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, 779 00 Olomouc, Czech Republic; (Z.H.); (J.K.); (Z.K.)
| | - Jana Knillova
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, 779 00 Olomouc, Czech Republic; (Z.H.); (J.K.); (Z.K.)
| | - Zdenek Kolar
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, 779 00 Olomouc, Czech Republic; (Z.H.); (J.K.); (Z.K.)
| | - Jana Vrbkova
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic;
| | - Milan Kral
- Department of Urology, University Hospital, 779 00 Olomouc, Czech Republic
- Correspondence: (M.K.); (J.B.)
| | - Jan Bouchal
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, 779 00 Olomouc, Czech Republic; (Z.H.); (J.K.); (Z.K.)
- Correspondence: (M.K.); (J.B.)
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15
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Hasan IA, Gaidan HA, Al-Kaabi MM. Diagnostic Value of Cytokeratin 34 beta E12 (Ck34βE12) and α-Methylacyl-CoA racemase ( AMACR) Immunohistochemical Expression in Prostatic Lesions. Iran J Pathol 2020; 15:232-238. [PMID: 32754219 PMCID: PMC7354068 DOI: 10.30699/ijp.2020.113544.2229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 04/10/2020] [Indexed: 11/06/2022]
Abstract
Background & Objective Some prostatic lesions contain small suspicious foci for prostatic carcinoma in which the morphological features are equivocal. Two immunohistochemical markers namely, cytokeratin 34 beta E12 (Ck34βE12) and α-Methylacyl-CoA racemase (AMACR), were evaluated in these lesions for a definitive diagnosis and avoiding misdiagnosis or overdiagnosis of prostatic carcinoma. Methods A total of 90 paraffin embedded blocks of prostatic tissue were selected and categorized into three groups as follows: 50 cases of benign prostatic hyperplasia (BPH), 20 cases of prostatic carcinoma, and 20 cases of benign prostatic lesions with suspicious foci labeled as ASAP (atypical small acinar proliferation) that occupy not more than 5% of the lesion. These cases were revised for histopathological diagnosis and stained with two immunohistochemical markers: Ck34βE12 and AMACR. Results While 92.9% of BPH were positive for Ck34βE12, 96% of prostatic carcinoma were negative for this marker (P=0.0001). Regarding AMACR, 92.9% of BPH cases were negative, but 92% of prostatic carcinoma cases were positive for this marker (P=0.0001). Out of 20 cases of BPH, 15 cases containing suspicious foci showed Ck34βE12+/AMACR- (diagnosis: benign), but 5 cases were Ck34βE12-/AMACR+, for which the diagnosis changed to prostatic carcinoma (P=0.04). Conclusion Immunohistochemical staining with Ck34βE12 and AMACR improved the diagnostic performance and increased confidence level for establishing definite diagnosis in cases with suspicious foci, in which the morphological features were equivocal. This could help to avoid misdiagnosis or overdiagnosis of prostatic carcinoma that would eventually improve the management of the patient and subsequently the prognosis.
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Affiliation(s)
- Ikram A Hasan
- Pathology and Forensic Medicine Department, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Hiba Ahmed Gaidan
- Pathology and Forensic Medicine Department, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Methaq Mueen Al-Kaabi
- Pathology and Forensic Medicine Department, College of Medicine, Mustansiriyah University, Baghdad, Iraq
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Xie H, Nie L, Zhang M, Su Z, Chen X, Xu M, Gong J, Chen N, Zhou Q. Suppression of α-methylacyl-coenzyme A racemase by miR200c inhibits prostate adenocarcinoma cell proliferation and migration. Exp Ther Med 2019; 19:1806-1816. [PMID: 32104236 PMCID: PMC7027128 DOI: 10.3892/etm.2019.8406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 10/02/2019] [Indexed: 02/05/2023] Open
Abstract
Overexpression of α-methylacyl-coenzyme A racemase (AMACR/P504S) is a major abnormality that has been observed in prostate cancer, whereas microRNA (miRNA/miR) 200c, is downregulated. The aim of the present study was to explore whether miR200c was able to exert any regulatory effects on AMACR. To meet this aim, bioinformatics analysis was performed to identify potential binding sites for miR200c in the 3′-untranslated region (3′-UTR) of AMACR. Recombinant adenoviral and dual reporter gene assays were designed to examine the binding of miR200c to the potential seed sequences in the AMACR 3′-UTR. Conventional reverse transcription (RT)-PCR, RT-quantitative (q)PCR and western blotting were also used to examine the regulatory effects of miR200c on AMACR at the mRNA and protein levels. Furthermore, Cell Counting Kit-8, wound healing and Transwell assays were performed to investigate the biological effects of miR200c-AMACR deregulation on prostate cancer cell proliferation, migration and invasion. It was revealed that miR200c post-transcriptionally suppressed AMACR expression by interacting with the 90–97 nucleotide sequence of the AMACR mRNA 3′-UTR. Artificial overexpression of miR200c significantly downregulated the mRNA and protein levels of AMACR in DU145 and PC-3 prostate cancer cells. Knockdown of AMACR by RNA interference, or overexpression of miR200c by recombinant adenoviral Ad-miR200c, inhibited prostate cancer cell proliferation, migration and invasiveness. Taken together, the results of the present study revealed that miR200c may suppress the AMACR expression level post-transcriptionally. The results also indicate that perturbation of the miR200c-AMACR regulatory mechanism may be involved in prostate carcinogenesis and that this may be exploited in future therapeutic approaches to prostate cancer.
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Affiliation(s)
- Hanbing Xie
- Pathology Department and State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Ling Nie
- Pathology Department and State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Mengni Zhang
- Pathology Department and State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Zhengzheng Su
- Pathology Department and State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xueqin Chen
- Pathology Department and State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Miao Xu
- Pathology Department and State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Jing Gong
- Pathology Department and State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Ni Chen
- Pathology Department and State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Qiao Zhou
- Pathology Department and State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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Rathod SG, Jaiswal DG, Bindu RS. Diagnostic utility of triple antibody ( AMACR, HMWCK and P63) stain in prostate neoplasm. J Family Med Prim Care 2019; 8:2651-2655. [PMID: 31548949 PMCID: PMC6753827 DOI: 10.4103/jfmpc.jfmpc_432_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/06/2019] [Accepted: 06/20/2019] [Indexed: 11/04/2022] Open
Abstract
Aims and Objective: In recent period, basal cell markers high molecular weight cytokeratin (HMWCK), P63 and prostate biomarker AMACR have been used as adjuvant to morphology in diagnostically challenging cases with a very high sensitivity and specificity. Materials and Methods: In this prospective study, total of 80 cases including 40 cases of malignant lesions and 40 cases of benign lesions of the prostate were taken. Tumor grade was determined according to Gleason's grading system. AMACR, HMWCK, P63 expressions were determined by immunohistochemical staining. Results: This study showed AMACR had a sensitivity of 90%, specificity of 100%. AMACR was not expressed in any of the 40 cases of benign lesions of the prostate while in malignant lesions of prostate it was expressed in 36 of 40 (90%) cases; 15 of 16 (93%) of well-differentiated carcinoma were positive for AMACR expression; 17 of 19 (89.47%) moderately differentiated and 4 of 5 (80%) cases of poorly differentiated tumors were positive for AMACR. There was statistically significant difference in expression of AMACR between benign and malignant lesions of the prostate (P = 0.001). In benign lesions, HMWCK and P63 were expressed in all the 40 (100%) cases, while in malignant lesions of prostate it was not expressed in any of the (0%) case. AMACR expression was not seen in any of the benign lesion. Out of 40 malignant cases, 4 cases were negative for AMACR, HMWCK and P63, 36 cases were positive only for AMACR, but no case was positive for HMWCK and P63. Conclusions: As an adjunct to biopsy, AMACR, HMWCK and P63 have potential for combating diagnostically challenging cases.
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Affiliation(s)
- Santosh G Rathod
- Department of Pathology, Government Medical College and Cancer Hospital, Aurangabad, Maharashtra, India
| | - Deelip G Jaiswal
- Department of Pathology, Government Medical College and Cancer Hospital, Aurangabad, Maharashtra, India
| | - Rajan S Bindu
- Department of Pathology, Government Medical College and Cancer Hospital, Aurangabad, Maharashtra, India
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Alston ELJ, Zynger DL. Does the addition of AMACR to CK20 help to diagnose challenging cases of urothelial carcinoma in situ? Diagn Pathol 2019; 14:91. [PMID: 31419984 PMCID: PMC6697956 DOI: 10.1186/s13000-019-0871-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 08/09/2019] [Indexed: 12/02/2022] Open
Abstract
Background Urothelial carcinoma in situ (CIS) in the bladder can be difficult to diagnose due to factors including procedural artifact, minimal tissue sampled, therapy-related changes, and various CIS growth patterns. Prior data has demonstrated an increase in alpha-methylacyl-CoA-racemase (AMACR) in urothelial CIS, but there is no information on its utility for diagnosing difficult cases. The aim of this investigation was to assess the expression of AMACR that was ordered on equivocal bladder cases during clinical practice. Methods Transurethral resections of the bladder in which AMACR and CK20 were performed during diagnostic workup were identified and cases with a final diagnosis of CIS (n = 22) or non-neoplastic urothelium (n = 30) were selected. Additionally, cases in which a diagnosis of CIS was rendered without IHC (n = 20) were selected and tested for AMACR expression. Results Sensitivity of AMACR for CIS diagnosed with IHC during clinical practice was 73% and specificity was 97%, while CK20 was 95% sensitive and 80% specific. Sensitivity of AMACR in CIS diagnosed without IHC was 100%. In all groups, AMACR had inconsistent intensity, compared to CK20 which had consistent, strong intensity. Conclusions AMACR was usually positive in urothelial CIS and negative in non-neoplastic urothelium. However, it is important to note that AMACR was less sensitive in difficult cases, while CK20 was more sensitive with more consistent, strong staining compared to AMACR.
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Affiliation(s)
- Erin L J Alston
- Department of Pathology, The Ohio State University Medical Center, 410 W 10th Ave., 401 Doan Hall, Columbus, OH, 43210, USA
| | - Debra L Zynger
- Department of Pathology, The Ohio State University Medical Center, 410 W 10th Ave., 401 Doan Hall, Columbus, OH, 43210, USA.
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Pal M, Easton NM, Yaphe H, Bearne SL. Potent dialkyl substrate-product analogue inhibitors and inactivators of α-methylacyl-coenzyme A racemase from Mycobacterium tuberculosis by rational design. Bioorg Chem 2018; 77:640-650. [PMID: 29502025 DOI: 10.1016/j.bioorg.2018.01.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/28/2018] [Accepted: 01/30/2018] [Indexed: 12/15/2022]
Abstract
Rational approaches for the design of enzyme inhibitors furnish powerful strategies for developing pharmaceutical agents and tools for probing biological mechanisms. A new strategy for the development of gem-disubstituted substrate-product analogues as inhibitors of racemases and epimerases is elaborated using α-methylacyl-coenzyme A racemase from Mycobacterium tuberculosis (MtMCR) as a model enzyme. MtMCR catalyzes the epimerization at C2 of acyl-CoA substrates, a key step in the metabolism of branched-chain fatty acids. Moreover, the human enzyme is a potential target for the development of therapeutic agents directed against prostate cancer. We show that rationally designed, N,N-dialkylcarbamoyl-CoA substrate-product analogues inactivate MtMCR. Binding greatly exceeds that of the substrate, (S)-ibuprofenoyl-CoA, up to ∼250-fold and is proportional to the alkyl chain length (4-12 carbons) with the N,N-didecyl and N,N-didodecyl species having competitive inhibition constants with values of 1.9 ± 0.2 μM and 0.42 ± 0.04 μM, respectively. The presence of two decyl chains enhanced binding over a single decyl chain by ∼204-fold. Overall, the results reveal that gem-disubstituted substrate-product analogues can yield extremely potent inhibitors of an epimerase with a capacious active site.
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Affiliation(s)
- Mohan Pal
- Department of Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Nicole M Easton
- Department of Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Hannah Yaphe
- Department of Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Stephen L Bearne
- Department of Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS B3H 4R2, Canada; Department of Chemistry, Dalhousie University, Halifax, NS B3H 4R2, Canada.
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He HL, Lee YE, Chang MT, Shiue YL, Chang SL, Chen TJ, Chiu CT. AMACR overexpression acts as a negative prognostic factor in oral squamous cell carcinoma. Int J Med Sci 2018; 15:638-644. [PMID: 29725255 PMCID: PMC5930466 DOI: 10.7150/ijms.23291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 03/02/2018] [Indexed: 12/28/2022] Open
Abstract
Background: Alpha-methylacyl-CoA racemase (AMACR) is a key enzyme responsible for the metabolism of branched-chain fatty acids. It has been found to be an important prognostic factor in numerous types of cancers. This study was aimed to investigate the expression of AMACR and its prognostic significance in patients with oral squamous cell carcinoma (SCC). Methods: Analysis of publicly available microarray data of oral SCC revealed that AMACR was significantly upregulated in tumor tissue compared with normal mucosa. We further assessed the protein expression of AMACR in 164 patients with oral SCC by immunohistochemistry. The prognostic impact of AMACR expression and its association with various clinicopathological parameters were statistically analyzed. Results: AMACR overexpression was significantly associated with advanced tumor status (P=0.001), advanced nodal status (P=0.036), increased vascular invasion (P=0.026) and increased perineural invasion (P=0.004). Patients with high expression level of AMACR had significantly worse disease-specific survival (DSS), distant metastasis-free survival (DMFS) and local recurrence-free survival (LRFS) (all P<0.0001). In multivariate analysis, AMACR overexpression was also an independent negative prognostic factor for DSS (hazard ratio [HR]: 4.410, 95% confidence interval [CI]: 2.285-8.511, P<0.001), DMFS (HR: 5.157, 95% CI: 2.756-9.651, P<0.001) and LRFS (HR: 4.462, 95% CI: 2.429-8.198, P<0.001). Conclusions: High expression of AMACR was not only a key adverse prognostic factor but also a potential therapeutic target in oral SCC.
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Affiliation(s)
- Hong-Lin He
- Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan.,Department of Pathology, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Ying-En Lee
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Min-Te Chang
- Department of Oral and Maxillofacial Surgery, Chi Mei Medical Center, Tainan, Taiwan
| | - Yow-Ling Shiue
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Shih-Lun Chang
- Department of Otolaryngology, Chi Mei Medical Center, Yongkang District, Tainan City, Taiwan.,Department of Optometry, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Tzu-Ju Chen
- Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan.,Department of Optometry, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Chang-Ta Chiu
- Department of Oral & Maxillofacial Surgery, An Nan Hospital, China Medical University, Tainan, Taiwan
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21
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Bachurska SY, Staykov DG, Bakardzhiev IV, Antonov PA, Belovezhdov VT. Diagnostic Value of ERG in Prostate Needle Biopsies Containing Minute Cancer Foci. Folia Med (Plovdiv) 2017; 59:84-90. [PMID: 28384107 DOI: 10.1515/folmed-2017-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 07/19/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Prostate carcinoma (PC) is the second most diagnosed cancer in men population worldwide. The small amount of the tissue in prostate needle biopsy is often sufficient for the correct interpretation. Novel antibodies, as ERG, could add to the diagnostic value of IHC study in analysing difficult core biopsies. AIM The aim of the present study was to establish a diagnostic use of ERG in a work-up of prostate needle biopsies containing minute PC, individually and in combination with AMACR/34βE12. MATERIALS AND METHODS From total number of 1710 consecutive prostate needle biopsies based on HE stain 114 biopsies containing minute PC. Selected biopsies were incubated with anti-ERG, AMACR and 34βE12 antibodies using immunohistochemical technique. RESULTS Among 98 selected biopsies, 57 showed positive and 41 negative ERG staining. AMACR staining was positively expressed in 86 of the cases and completely absent in remaining 12. In 9 of the AMACR-negative cases the final diagnosis was establish by manifestation of ERG expression in the tumour foci. 95 of the biopsies demonstrated lack of 34βE12 expression and only 3 cases showed weak patchy staining. Among these cases 2 were ERG-positive. CONCLUSION ERG antibody could be especially helpful in the cases with controversial expression of AMACR and 34βE12.
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Affiliation(s)
- Svitlana Y Bachurska
- Department of General and Clinical Pathology and Forensic Medicine, Medical University of Plovdiv, 15A Vasil Aprilov Blvd., 4002 Plovdiv, Bulgaria
| | - Dmitriy G Staykov
- Department of General and Clinical Pathology and Forensic Medicine, Medical University of Plovdiv, 15A Vasil Aprilov Blvd., 4002 Plovdiv, Bulgaria
| | | | - Petar A Antonov
- Department of Urology, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Veselin T Belovezhdov
- Department of General and Clinical Pathology and Forensic Medicine, Medical University of Plovdiv, 15A Vasil Aprilov Blvd., 4002 Plovdiv, Bulgaria
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22
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Kovaleva OV, Samoilova DV, Shitova MS, Oleinikova NA, Danilova NV, Malkov PG, Gratchev A. A Novel Monoclonal Antibody Against Alpha-Methylacyl-CoA Racemase Applicable for Paraffin-Embedded Tissues and Diagnostics of Prostate Cancer. Monoclon Antib Immunodiagn Immunother 2017; 36:30-34. [PMID: 28234557 DOI: 10.1089/mab.2016.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AMACR (alpha-methylacyl-CoA racemase) has been recently described as a prostate cancer-specific gene that encodes a protein involved in the beta-oxidation of branched chain fatty acids. Expression of AMACR protein is found in prostatic adenocarcinoma, but not in benign prostatic tissue. Thus, monoclonal antibodies (mAbs) for AMACR detection are an important tool for the diagnosis of AMACR-positive cancers. However, only a few mAbs, especially those applicable for immunohistochemistry (IHC), have been established to date. In this study, we describe the generation of a new hybridoma clone G8 producing anti-AMACR antibodies. G8 mAb specifically binds human AMACR and was successfully used in immunoblotting and immunofluorescence on paraformaldehyde-fixed cells and in IHC of paraffin-embedded tumor specimens. These results indicate that this new anti-AMACR mAb G8 would be useful in the diagnosis of AMACR-related cancers and would be a strong tool in both basic and clinical research on AMACR.
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Affiliation(s)
- Olga V Kovaleva
- 1 Institute of Carcinogenesis , NN Blokhin Russian Cancer Research Center, Moscow, Russia
| | - Daria V Samoilova
- 1 Institute of Carcinogenesis , NN Blokhin Russian Cancer Research Center, Moscow, Russia
| | - Maria S Shitova
- 1 Institute of Carcinogenesis , NN Blokhin Russian Cancer Research Center, Moscow, Russia
| | | | | | | | - Alexei Gratchev
- 1 Institute of Carcinogenesis , NN Blokhin Russian Cancer Research Center, Moscow, Russia .,3 Medical Faculty Mannheim, Ruprecht-Karls University of Heidelberg , Mannheim, Germany
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23
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López-Valdivia CM, González-Matea M, Mayordomo E, Hervás D, Ramos D. [The value of alpha-methylacyl-CoA racemase expression in the progression of colonic carcinoma]. Rev Esp Patol 2017; 50:15-21. [PMID: 29179959 DOI: 10.1016/j.patol.2016.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/04/2016] [Accepted: 04/09/2016] [Indexed: 06/07/2023]
Abstract
Alpha-methylacyl-CoA racemase (AMACR) expression has been demonstrated in several normal tissues and in diverse types of carcinoma. Our aim was to analyze the immunohistochemical expression of AMACR in the sequence-progression of colonic cancer. We studied 237 cases, including samples of normal mucosa of the colon, adenomas with different degrees of dysplasia, colonic carcinomas, lymph nodes and liver metastases of colonic carcinomas. A scale of intensity and percentage of expression was used to analyze the AMACR immunohistochemical profile. The expression was nearly absent in samples of normal mucosa, increased in both adenomas and carcinomas, decreased in lymph node metastases but was significantly increased in liver metastases.
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Affiliation(s)
| | - Manuel González-Matea
- Servicio de Anatomía Patológica, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - Empar Mayordomo
- Servicio de Anatomía Patológica, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - David Hervás
- Unidad de Bioestadística, Instituto de Investigación Sanitaria La Fe, Valencia, España
| | - David Ramos
- Servicio de Anatomía Patológica, Hospital Universitario y Politécnico La Fe, Valencia, España
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24
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Nowroozi M, Ayati M, Amini E, Mahdian R, Yousefi B, Arbab A, Jamali Zawarei M, Niroomand H, Ghorbani H, Ghadian A. Is There a Role for Genetic Information in Risk Assessment and Decision Making in Prostate Cancer? Nephrourol Mon 2016; 8:e41505. [PMID: 27933279 PMCID: PMC5135728 DOI: 10.5812/numonthly.41505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 10/15/2016] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Prostate cancer is a neoplasm with a variable natural history and clinical behavior. There is much debate on the use of inherited genetic information in clinical application including risk assessment and treatment decisions. This study was performed to evaluate the relationship between clinical parameters of prostate cancer (PSA, Gleason score, and metastasis) and expression of NKX3.1, AMACR, TMPRSS2-ERG, ERG, and SPINK1 genes. METHODS Newly diagnosed cases of prostate cancer were selected for this study. Thirty four tissue samples were obtained via open radical prostatectomy and 9 samples were obtained via needle biopsy. Each tissue sample was sectioned into two parts, one used for detection of malignant changes and Gleason score determination, and the other immersed in RNA later solution (Qiagen). The expression of NKX3.1, AMACR, TMPRSS2-ERG, ERG, and SPINK1 genes were assessed by real-time PCR assay. Correlation between expression of each gene and PSA level, Gleason score, and presence of metastasis were examined. RESULTS A total number of 43 specimens were studied, from which 9 were obtained from patients with metastatic prostate cancer. The expression of five examined genes had no correlation with PSA level and Gleason score. The expression of AMACR decreased in metastatic prostate cancer (P = 0.02). The expression of other genes showed no difference between metastatic and non-metastatic tumors (P > 0.1). CONCLUSIONS Genetic information combined with clinical data can be useful in risk assessment and treatment planning. Based on the results of the current study, the decreased expression of AMACR was a sign of poor prognosis.
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Affiliation(s)
- Mohamadreza Nowroozi
- Uro-Oncology Research Center (UORC), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Ayati
- Uro-Oncology Research Center (UORC), Tehran University of Medical Sciences, Tehran, Iran
| | - Erfan Amini
- Uro-Oncology Research Center (UORC), Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mahdian
- Biotechnology Research Center, Molecular Medicine Department, Pasteur Institue of Iran, Tehran, Iran
| | - Behzad Yousefi
- Uro-Oncology Research Center (UORC), Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Arbab
- Uro-Oncology Research Center (UORC), Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Hamidreza Ghorbani
- Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Corresponding author: Hamidreza Ghorbani, MD, Uro-Oncologist, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Tel: +98-9151103416, Fax: +98-5138598946, E-mail:
| | - Alireza Ghadian
- Nephrology and Urology Research Center, Baqiyatallah University Medical Sciences, Tehran, Iran
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25
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Korshak OV, Sushilova EN, Voskresenskii MA, Grozov RV, Komyakov BK, Zarytskey AY, Popov BV. [Basal-luminal epithelial cell differentiation in prostate cancer is associated with epithelial-mesenchymal transition and epithelium migration in the mesenchyme]. Urologiia 2016:85-91. [PMID: 28248026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM In patients with prostate cancer to trace the pathway of the malignant cells of the basal layer of the prostate epithelium during their differentiation into luminal cells and/or migration in the mesenchyme. MATERIALS AND METHODS We used histological and immunohistochemical staining of the markers of the basal layer of the prostate: cytokeratin 5 (CK5), E-cadherin and AMACR, and Western blot to assess the production of the same markers in epithelial and stromal compartments of malignant and normal prostate tissue in patients with prostate cancer. RESULTS Our findings revealed that prostate cancer is associated with losing of the basal epithelial layer in the prostate tumor tissue, which is accompanied by a complete loss of CK5 secretion, increased levels of E-cadherin and AMACR in luminal epithelium and the emergence of cells producing E-cadherin and AMACR in the stromal compartment of the prostate. DISCUSSION These findings suggest that in prostate cancer the transformation the basal layer of the epithelial cells is associated with their differentiation into luminal cells and migration into the surrounding mesenchyme due to epithelial-mesenchymal transition. CONCLUSION Prostate cancer pathogenesis of associated with changes in epithelial cell pathways and the levels of the markers expression. Their assessment can be used for studying the disease mechanisms and seeking new diagnosis and treatment options.
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Affiliation(s)
- O V Korshak
- Almazov North-Western Federal Medical Research Centre, St.Petersburg
| | | | | | - R V Grozov
- Almazov North-Western Federal Medical Research Centre, St.Petersburg
| | - B K Komyakov
- Multidisciplinary City Hospital 2, St.Petersburg
| | - A Y Zarytskey
- Almazov North-Western Federal Medical Research Centre, St.Petersburg
| | - B V Popov
- Institute of Cytology RAS, St.Petersburg
- I.I. Mechnikov North-Western State Medical University, Minzdrav, Russia
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26
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Goldstein J, Goyal R, Roland JT, Gellert LL, Clark PE, Hameed O, Giannico GA. MAGI-2 Is a Sensitive and Specific Marker of Prostatic Adenocarcinoma: A Comparison With AMACR. Am J Clin Pathol 2016; 146:294-302. [PMID: 27543977 DOI: 10.1093/ajcp/aqw111] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES We compared the utility of membrane-associated guanylate kinase, WW and PDZ domain-containing protein 2 (MAGI-2) and α-methylacyl CoA (AMACR) by immunohistochemistry in diagnosing prostatic adenocarcinoma. METHODS Seventy-eight radical prostatectomies were used to construct three tissue microarrays with 512 cores, including benign prostatic tissue, benign prostatic hyperplasia, high-grade prostatic intraepithelial neoplasia (HGPIN), and adenocarcinoma. AMACR and MAGI-2 immunohistochemistry were evaluated by visual and image analysis. RESULTS MAGI-2 and AMACR were significantly higher in adenocarcinoma and HGPIN compared with benign tissue. At H-score cutoffs of 300 and 200, MAGI-2 was more accurate in distinguishing benign from malignant glands than AMACR. Areas under the curve by image and visual analysis were 0.846 and 0.818 for MAGI-2 and 0.937 and 0.924 for AMACR, respectively. The accuracy of MAGI-2 in distinguishing benign from malignant glands on the same core was higher (95% vs 88%). CONCLUSIONS MAGI-2 could represent a useful adjunct for diagnosis of prostatic adenocarcinoma, especially when AMACR is not discriminatory.
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Affiliation(s)
| | - Rajen Goyal
- From the Department of Pathology, Microbiology, and Immunology
| | | | - Lan L Gellert
- From the Department of Pathology, Microbiology, and Immunology
| | - Peter E Clark
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Omar Hameed
- From the Department of Pathology, Microbiology, and Immunology Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.
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27
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Box A, Alshalalfa M, Hegazy SA, Donnelly B, Bismar TA. High alpha-methylacyl-CoA racemase ( AMACR) is associated with ERG expression and with adverse clinical outcome in patients with localized prostate cancer. Tumour Biol 2016; 37:12287-99. [PMID: 27271990 DOI: 10.1007/s13277-016-5075-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/05/2016] [Indexed: 10/21/2022] Open
Abstract
Alpha-methylacyl-CoA racemase (AMACR) is a well-characterized marker extensively utilized in prostate cancer (PCA) diagnosis. However, the prognostic value of AMACR expression and its relation to TMPRSS2-ERG gene rearrangement as one of the most common molecular alterations in PCA is not fully explored. AMACR expression was investigated in a cohort of 218 men with localized PCA treated by radical prostatectomy and correlated with ERG and various clinical and pathological parameters. In vitro studies assessed AMACR changes to ERG knockdown and other related genes. In addition, bioinformatics validated the significance of AMACR/ERG expression and assessed relevant genetic signatures in relation to AMACR/ERG expression. AMACR expression was significantly associated with disease progression and with ERG (p ∼0). Seventeen percent of cancer foci showed negative/weak AMACR expression while being ERG positive. High AMACR expression was significantly associated with positive surgical margins (p = 0.01), specifically in tumors with lower Gleason score <7, with ∼95 % exhibiting positive surgical margin (p = 0.008). High AMACR showed marginal association with PSA biochemical recurrence (BCR) (p = 0.06) which was slightly more pronounced in ERG-positive tumors (p = 0.04). This was validated in other public cohorts. However, in this cohort, the association with BCR was not statistically significant in multivariate analysis (p = 0.09). Using in vitro cellular models, AMACR messenger RNA (mRNA) expression, but not protein levels, showed an association with ERG expression. We report for the first time a significant association between AMACR and ERG with prognostic implication. Patients with high AMACR/ERG-positive PCA may be at higher risk for disease progression, and additional studies in larger cohorts are needed to confirm the above findings. Functional studies investigating the molecular pathways connecting AMACR and ERG may provide an additional insight into PCA progression pathways.
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28
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Abstract
BACKGROUND Prostate needle biopsy (PNB) is required for the diagnosis of prostate cancer (PCa), but little is known about the frequency and clinical implication of false-negative results. OBJECTIVE To investigate the incidence and clinical impact of minute PCa missed on routine haematoxylin and eosin (H&E) slides, but retrieved by α-methylacyl-CoA-racemase (AMACR) immunohistochemistry. METHODS AMACR immunohistochemistry was used to detect PCa missed on H&E slides in a series of consecutive 1,672 PNB including 1,003 patients without evidence of PCa, and 669 patients with PCa meeting pathological criteria for active surveillance (PCAS) under current clinical investigation, including Gleason score ≤7 (3 + 4), <33% of biopsies involved by cancer, <50% of any core involved by cancer. Using improved multicore (pre-) embedding techniques a single AMACR immunostain/patient was sufficient to detect missed lesions. RESULTS In patients without histological evidence of PCa, AMACR immunohistochemistry retrieved minute PCa in 33 of 1,003 patients (3.29%) and atypical small acinar proliferations (ASAP) in 17 of 1,003 patients (1.69%). Among 116 of 669 (17.34%) PCa patients meeting PCAS, detection of additional core(s) involved by cancer was found responsible for disease reclassification in 63 of 116 of patients (54.31%). Limitations include the single-institutional design of the study. CONCLUSIONS PCa missed on routine H&E histology was retrieved by AMACR in 8.91% of PNB, including 17.34% of PCa patients meeting PCAS. 54.31% of them have finally lost their eligibility for active surveillance after detecting additional cores involved by cancer. Underdiagnosis of limited adenocarcinoma on PNB is a matter of concern, but can be prevented by a single AMACR immunostain/patient if improved multicore (pre-) embedding techniques are used.
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29
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Kansal S, Chopra P, Dhawan S. AMACR Positive Papillary Renal Adenomatosis and Multifocal Papillary Carcinoma in End Stage Renal Disease. Indian J Surg Oncol 2015; 9:247-250. [PMID: 29887709 DOI: 10.1007/s13193-015-0444-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 07/01/2015] [Indexed: 11/29/2022] Open
Abstract
Immunomarker α-methylacyl-coenzyme A racemase (AMACR), a protein involved in the metabolism of branched chain fatty acids was initially recognized in the evaluation of prostate cancer. AMACR is also a fairly sensitive marker for papillary renal cell carcinoma. Papillary adenoma associated with papillary renal cell carcinoma are AMACR positive and both represent a continuum of the same biological process. However, the papillary adenomas associated with end-kidney and/or acquired cystic disease are AMACR negative. Herein, we report a case of AMACR positive renal adenomatosis with tiny foci of papillary carcinoma in a background of end stage kidney disease and nephrolithiasis. AMACR staining pattern in renal papillary adenomas needs more evaluation to better understand their pathogenesis under different settings.
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Affiliation(s)
- Surbhi Kansal
- Sir GangaRam Hospital, Rajinder Nagar, New Delhi, 110060 India
| | - Prem Chopra
- Sir GangaRam Hospital, Rajinder Nagar, New Delhi, 110060 India
| | - Shashi Dhawan
- Sir GangaRam Hospital, Rajinder Nagar, New Delhi, 110060 India
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30
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Kataria Y, Wright M, Deaton RJ, Rueter EE, Rybicki BA, Moser AB, Ananthanrayanan V, Gann PH. Dietary influences on tissue concentrations of phytanic acid and AMACR expression in the benign human prostate. Prostate 2015; 75:200-10. [PMID: 25307752 PMCID: PMC4778716 DOI: 10.1002/pros.22905] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 08/26/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND Alpha-methylacyl-CoA racemase (AMACR) is an enzyme involved in fatty acid metabolism that is markedly over-expressed in virtually all prostate cancers (PCa), relative to benign tissue. One of AMACR's primary substrates, phytanic acid, is derived predominately from red meat and dairy product consumption. Epidemiological evidence suggests links between dairy/red meat intake, as well as phytanic acid levels, and elevated PCa risk. This study investigates the relationships among dietary intake, serum and tissue concentrations of phytanic acid, and AMACR expression (mRNA and protein) in the histologically benign human prostate. METHODS Men undergoing radical prostatectomy for the treatment of localized disease provided a food frequency questionnaire (n = 68), fasting blood (n = 35), benign fresh frozen prostate tissue (n = 26), and formalin-fixed paraffin-embedded (FFPE) sections (n = 67). Serum and tissue phytanic acid concentrations were obtained by gas chromatography-mass spectrometry. We extracted RNA from epithelial cells using laser capture microdissection and quantified mRNA expression of AMACR and other genes involved in the peroxisomal phytanic acid metabolism pathway via qRT-PCR. Immunohistochemistry for AMACR was performed on FFPE sections and subsequently quantified via digital image analysis. Associations between diet, serum, and tissue phytanic acid levels, as well as AMACR and other gene expression levels were assessed by partial Spearman correlation coefficients. RESULTS High-fat dairy intake was the strongest predictor of circulating phytanic acid concentrations (r = 0.35, P = 0.04). Tissue phytanic acid concentrations were not associated with any dietary sources and were only weakly correlated with serum levels (r = 0.29, P = 0.15). AMACR gene expression was not associated with serum phytanic acid (r = 0.13, P = 0.47), prostatic phytanic acid concentrations (r = 0.03, P = 0.88), or AMACR protein expression (r = -0.16, P = 0.20). CONCLUSIONS Our data underscore the complexity of the relationship between AMACR and its substrates and do not support the unifying hypothesis that excess levels of dietary phytanic acid are responsible for both the overexpression of AMACR in prostate cancer and the potential association between PCa risk and intake of dairy foods and red meat.
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Affiliation(s)
- Yachana Kataria
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
| | | | - Ryan J. Deaton
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
| | - Erika Enk Rueter
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
| | - Benjamin A. Rybicki
- Department of Public Health Sciences, Henry Ford Health Systems, Detroit, Michigan
| | - Ann B. Moser
- Peroxisomal Diseases Lab, Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland
| | | | - Peter H. Gann
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
- Correspondence to: Peter H. Gann, MD, ScD, Department of Pathology (MC 847), College of Medicine, 840 S. Wood Street, Chicago, IL 60612.
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31
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Iczkowski KA. Paneth cell-like change in benign prostate can account for P504S ( AMACR) reactivity. Int J Clin Exp Pathol 2014; 7:3454-3455. [PMID: 25031776 PMCID: PMC4097236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 05/25/2014] [Indexed: 06/03/2023]
Abstract
Paneth cell-like neuroendocrine metaplasia of benign and cancerous prostate was described in 1992. Here, we note that P504S (AMACR), the cytoplasmic marker for prostate cancer used alone or in concert with basal cell markers, can be strongly reactive in benign prostatic acini with Paneth cell-like change.
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32
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Fadare O, Parkash V, Gwin K, Hanley KZ, Jarboe EA, Liang SX, Quick CM, Zheng W, Rawish KR, Hecht JL, Desouki MM. Utility of α-methylacyl-coenzyme-A racemase (p504s) immunohistochemistry in distinguishing endometrial clear cell carcinomas from serous and endometrioid carcinomas. Hum Pathol 2013; 44:2814-21. [PMID: 24119561 DOI: 10.1016/j.humpath.2013.07.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 07/25/2013] [Accepted: 07/26/2013] [Indexed: 10/26/2022]
Abstract
The expression of α-methylacyl-coenzyme-A racemase (AMACR) has previously been reported in 75% to 100% of urethral/bladder clear cell carcinomas, tumors that are known to display broad phenotypic overlap with their identically named müllerian counterparts. Herein, we assess the utility of AMACR in distinguishing endometrial clear cell carcinomas (CCCs) from endometrial serous carcinomas (ESCs) and endometrial endometrioid carcinomas (EECs). A total of 111 endometrial carcinomas in a tissue microarray, including 49 CCCs, 13 ESCs, and 49 EECs, were assessed for AMACR immunoreactivity, with results scored semiquantitatively (scores 0, 1+, 2+, 3+ for 0%, 1%-5%, 6%-50%, >50% immunoreactive cells, respectively). Fifty (45%) of the 111 carcinomas were AMACR positive, with the following score distribution: CCC: 0 (n = 12), 1+ (n = 12), 2+ (n = 3), 3+ (n = 22); EEC: 0 (n = 38), 1+ (n = 4), 2+ (n = 4), 3+ (n = 3); ESC: 0 (n = 11), 1+ (n = 1), 2+ (n = 0), 3+ (n = 1). AMACR expression was significantly more frequent in CCC (75%) than in ESC (15%) or EEC (22%); P < .0001. The sensitivity and specificity of AMACR expression in classifying a carcinoma as CCC were 0.75 (95% confidence interval [CI], 0.61-0.86) and 0.79 (95% CI, 0.66-0.88), respectively, with an odds ratio of 11.62 (95% CI, 5-28; P < .001) and an area under the curve of 0.79 (95% CI, 0.68-0.88). These findings indicate that AMACR expression is strongly associated with CCC and displays a relatively robust diagnostic test performance. However, its practical utility may be limited by the focal nature of its expression in 32% of the AMACR-positive CCC cases as well as its expression in 15% to 22% of the non-CCC histotypes.
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Affiliation(s)
- Oluwole Fadare
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
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Carnell AJ, Kirk R, Smith M, McKenna S, Lian LY, Gibson R. Inhibition of human α-methylacyl CoA racemase ( AMACR): a target for prostate cancer. ChemMedChem 2013; 8:1643-7. [PMID: 23929631 DOI: 10.1002/cmdc.201300179] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 07/12/2013] [Indexed: 12/26/2022]
Abstract
The enzyme α-methylacyl CoA racemase (AMACR) is involved in the metabolism of branched-chain fatty acids and has been identified as a promising therapeutic target for prostate cancer. By using the recently available human AMACR from HEK293 kidney cell cultures, we tested a series of new rationally designed inhibitors to determine the structural requirements in the acyl component. An N-methylthiocarbamate (Ki=98 nM), designed to mimic the proposed enzyme-bound enolate, was found to be the most potent AMACR inhibitor reported to date.
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Affiliation(s)
- Andrew J Carnell
- Department of Chemistry, Robert Robinson Laboratories, University of Liverpool, Liverpool L69 7ZD (UK).
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Ozgur T, Atik E, Hakverdi S, Yaldiz M. The expressions of AMACR and iNOS in prostate adenocarcinomas. Pak J Med Sci 2013; 29:610-3. [PMID: 24353588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 09/06/2012] [Accepted: 02/13/2013] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Prostate cancer is the second leading cause of death in men. The localized disease often responds to conventional therapies like androgen ablation via castration and/or administration of chemical inhibitors but advanced disease resistant to any curative therapies is still challenge for investigators. There are increasing efforts to enhance the possibility of finding positive and sensitive immune markers for diagnosing and treating prostate cancer. The aim of this study was to investigate the expression patterns of AMACR and iNOS in prostate adenocarcinomas with different histopathologic grade. METHODOLOGY We applied immunohistochemical markers; AMACR and iNOS. Formalin-fixed parafin embedded tissues of 64 prostate needle biopsy specimens diagnosed as prostate adenocarcinoma between 2005-2010 years were included in the study. RESULTS AMACR expression were found in 58 (90.6%) and iNOS expression in 54 (84.4%) of 64 prostate adenocarcinomas. No significant relationship of AMACR and iNOS was obtained (p>0.05). There was no significant correlation of histopathologic grade of the tumors with AMACR and iNOS expression (p>0.05). CONCLUSIONS The expression of AMACR and iNOS might be important diagnostic immune markers for prostate adenocarcinomas especially in needle biopsies where the quantity and quality of tissue are limited.
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Can B, Uzuner HÖ, Selim Nural M, Büyükalpelli R. Incidentally detected renal adenomatosis in a patient with urolithiasis: a case report. Turk J Urol 2013; 39:56-60. [PMID: 26328080 DOI: 10.5152/tud.2013.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 07/16/2011] [Indexed: 11/22/2022]
Abstract
A renal epithelial tumor with a papillary or tubulopapillary pattern and a low nuclear grade is defined as a renal adenoma if its diameter is 5 mm or less. Two important issues related to the renal adenoma are the lack of exact criteria for the histopathological differentiation from a papillary renal cell carcinoma and the lack of consensus as to whether it is a precancerous lesion. Renal adenomatosis is very rarely seen entity entity characterized by multiple and usually bilateral adenomas. Innumerable adenomas, adenomatous transformations within a single tubule and adenomas measuring 7 mm or less, were detected in a 47-year-old man who underwent simple nephrectomy due to nonfunctional hydronephrosis secondary to urolithiasis. In this paper, our diagnostic approach to this fairly rare entity is discussed along with a brief literature review.
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Affiliation(s)
- Bilge Can
- Department of Pathology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Hatice Ölger Uzuner
- Department of Pathology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Mehmet Selim Nural
- Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Recep Büyükalpelli
- Department of Urology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
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Truong CD, Li W, Feng W, Cagle P, Khoury T, Alrawi S, Xie K, Yao J, Tan D. Alpha-methylacyl-CoA racemase expression is upregulated in gastric adenocarcinoma: a study of 249 cases. Int J Clin Exp Pathol 2008; 1:518-523. [PMID: 18787636 PMCID: PMC2480587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Accepted: 03/29/2008] [Indexed: 05/26/2023]
Abstract
Alpha-methylacyl-CoA racemase (AMACR [P504S]) is a mitochondrial and peroxisomal enzyme involved in beta-oxidation of dietary branched-chain fatty acids and their derivatives. Recent studies showed that AMACR is expressed in several neoplasms, including prostate and colon cancer. However, AMACR expression in gastric neoplasms has yet to be thoroughly investigated. Because AMACR overexpression in human solid tumors is a potential target for cancer treatment, we aimed to evaluate the expression of AMACR in a large cohort of patients with gastric adenocarcinoma. The study evaluated 249 primary gastric adenocarcinomas by immunohistochemistry. Nonneoplastic gastric tissue samples from various sites (antrum, body, fundus, and pylorus) were also examined. The immunopositivity of each sample was graded on a scale from 0 to 3 (0, no expression; 1, weak expression, 2, intermediate expression; 3, strong expression). We observed AMACR expression in 141 tumor cases: 44, 47, and 50 cases had weak, intermediate, and strong expression, respectively. Both intestinal and signet ring cell adenocarcinoma cases had overexpression of AMACR, however intestinal adenocarcinoma had significantly higher expression than did signet ring cell adenocarcinoma (p<0.05). Nonneoplastic gastric mucosa did not show AMACR expression. The results of our study demonstrate that AMACR expression is upregulated in gastric cancer, and suggest that further prospective studies to explore the potential role of AMACR as a therapeutic target for gastric cancer are warranted.
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Affiliation(s)
- Camtu D. Truong
- Department of Pathology, The University of Texas M. D. Anderson Cancer CenterHouston, TX, USA
| | - Wei Li
- The University of Texas Health Science Center at HoustonHouston, TX, USA
| | - Wei Feng
- The University of Texas Health Science Center at HoustonHouston, TX, USA
| | | | | | - Sadir Alrawi
- University of Florida Health Science CenterJacksonville, FL, USA
| | - Keping Xie
- Department of Gastrointestinal Oncology, The University of Texas M. D. Anderson Cancer CenterHouston, TX, USA
| | - James Yao
- Department of Gastrointestinal Oncology, The University of Texas M. D. Anderson Cancer CenterHouston, TX, USA
| | - Dongfeng Tan
- Department of Pathology, The University of Texas M. D. Anderson Cancer CenterHouston, TX, USA
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