title: Significance of overexpression of alpha methylacyl-coenzyme A racemase in hepatocellular carcinoma.
abstract: BACKGROUND
  alpha-Methylacyl-CoA racemase (AMACR), an immunomarker for prostatic adenocarcinoma, has been shown to be expressed in a variety of other neoplasms. This study aims to evaluate immunohistochemical expression of the AMACR in neoplastic and nonneoplastic liver lesions, and assess its value in the diagnosis of hepatocellular carcinoma (HCC).
  
  
  METHODS
  Formalin-fixed paraffin-embedded tissue sections of 51 HCC (14 well, 22 moderately and 15 poorly differentiated), 9 hepatocellular adenoma (HCA), 48 cirrhotic nodules (CN) and 16 normal liver tissues (NLT) were immunostained for AMACR.
  
  
  RESULTS
  Expression of AMACR is significantly enhanced in HCC tissue compared with non-HCC tissue. High expression of AMACR was found in 82% of HCC including 86% of well-differentiated HCC. In contrast, only 11% of HCA, 13% of CN and 6% of NLT showed high expression for AMACR. Clinicopathological evaluation showed a significant correlation between AMACR expression and venous invasion and capsular invasion by HCC.
  
  
  CONCLUSIONS
  Our results suggest that AMACR staining may serve as a useful marker for the differential diagnosis of well-differentiated HCC from HCA. Increased AMACR expression and its association with tumor venous invasion suggest that AMACR may play a role in HCC development and progression.
authors.affiliation: Department of Pathology, University of Texas Health Science Center at Houston, Houston, TX 77030, USA. wei.li@uth.tmc.edu
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Philip T
authors.initials: PT
authors.lastname: Cagle
authors.forename: Rafael C
authors.initials: RC
authors.lastname: Botero
authors.forename: John J
authors.initials: JJ
authors.lastname: Liang
authors.forename: Zhaoping
authors.initials: Z
authors.lastname: Zhang
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Tan
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000201:enzymology / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000201:enzymology / Q000473:pathology; D008875:Middle Aged; D019998:Racemases and Epimerases / Q000378:metabolism*
chemical_list: D019998:Racemases and Epimerases; C108352:alpha-methylacyl-CoA racemase