title: Expression of alpha-methylacyl-CoA racemase correlates with histopathologic grading in noninvasive bladder cancer.
abstract: Alpha-methylacyl-CoA racemase (AMACR, p504S), an enzyme involved in cellular energy metabolism by the oxidation of branched-chain fatty acids, is a biomarker that is known to be overexpressed in prostatic and colorectal carcinoma as well as in papillary renal cell carcinoma. We aimed to correlate its immunohistochemically detected expression with histopathological grading in noninvasive bladder cancer in order to hint at a so far unknown role of AMACR in the pathobiology of this tumor entity. Therefore, a cohort of 163 patients (mean age 65.3 years) diagnosed with noninvasive bladder cancer was immunohistochemically investigated in terms of AMACR expression. There was variable positive AMACR staining in 52 (31.9%) of the cases investigated. All tumors were graded by three independent clinical histopathologists according to the 1973 World Health Organization (WHO) and the 1998 WHO/International Society of Urological Pathology (ISUP) system. We found a significant positive correlation between AMACR expression and higher tumor grades using both histopathologic grading schemes. These novel findings clearly allow including high-grade noninvasive bladder carcinomas in the group of AMACR-positive neoplasms and might reflect a so far unknown role of AMACR racemase in the pathobiology and tumor cell energy metabolism of the latter tumor entity.
authors.affiliation: Department of Pathology, HELIOS Klinikum Bad Saarow, Charité-University Medicine Teaching Hospital, Pieskower Strasse 33, 15526, Bad Saarow, Germany. sven.gunia@helios-kliniken.de
authors.forename: Sven
authors.initials: S
authors.lastname: Gunia
authors.forename: Matthias
authors.initials: M
authors.lastname: May
authors.forename: Katharina
authors.initials: K
authors.lastname: Scholmann
authors.forename: Stephan
authors.initials: S
authors.lastname: Störkel
authors.forename: Bernd
authors.initials: B
authors.lastname: Hoschke
authors.forename: Stefan
authors.initials: S
authors.lastname: Koch
authors.forename: Manfred
authors.initials: M
authors.lastname: Dietel
authors.forename: Glen
authors.initials: G
authors.lastname: Kristiansen
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D015331:Cohort Studies; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008875:Middle Aged; D019998:Racemases and Epimerases / Q000096:biosynthesis*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000201:enzymology* / Q000473:pathology*; D019459:Urothelium / Q000201:enzymology
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D019998:Racemases and Epimerases; C108352:alpha-methylacyl-CoA racemase