title: The utility of alpha-methyl CoA racemase (P504S) expression as a marker of renal cell carcinomas.
abstract: BACKGROUND
  Renal cell tumours are numerous and heterogeneous. Because of their clinicopathological heterogeneity, their accurate diagnosis may be challenging. In case of an equivocal diagnosis, immunohistochemistry may be a useful mean of diagnosis. Recently, alpha-methyl CoA racemase has been identified as a useful marker in kidney cancers.
  
  
  OBJECTIVE
  Our objectives are to highlight the role of alpha-methyl CoA racemase (AMACR) as a diagnostic marker in papillary renal carcinoma and to assess its utility in the other tumour types.
  
  
  METHODS
  Aretrospective review was performed on 62 patients who were treated for renal tumours between January 1994 and November 2005. Immunoreactivity was evaluated with a qualitative manner. Positive AMACR staining was defined as a coarse dense cytoplasmic granularity.
  
  
  RESULTS
  The 62 renal tumours were diagnosed as papillary tumours in 22 cases, clear cell tumours in 18 cases, chromophobe carcinoma in 12 cases and oncocytoma in 10 cases among the 22 cases of papillary tumours, all the cases (100%) showed cytoplasmic immunoreactivity staining. 4 cases between the 18 clear cell carcinomas (22%) showed positivity with AMACR. The 12 cases of chromophobe carcinoma didn't express AMACR by immunohistochemistry. Only one case between the oncocytomas (1%) expressed AMACR.
  
  
  CONCLUSIONS
  This study confirms the high sensitivity of AMACR for papillary renal cell carcinomas but we must keep in mind that weak focal AMACR staining could be present in other renal cell carcinomas.
authors.affiliation: Department of Anatomopathology, Charles Nicolle Hospital, Tunis.
authors.forename: Nadia
authors.initials: N
authors.lastname: Kourda
authors.forename: Mona
authors.initials: M
authors.lastname: Mlika
authors.forename: Amine
authors.initials: A
authors.lastname: Derouiche
authors.forename: Yosra
authors.initials: Y
authors.lastname: Zidi-Moaffak
authors.forename: Mohamed
authors.initials: M
authors.lastname: Chebil
authors.forename: Rachida
authors.initials: R
authors.lastname: Zermani
authors.forename: Sara Ben
authors.initials: SB
authors.lastname: Jilani
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D002292:Carcinoma, Renal Cell / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007680:Kidney Neoplasms / Q000378:metabolism* / Q000473:pathology; D019998:Racemases and Epimerases / Q000378:metabolism*; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D019998:Racemases and Epimerases; C108352:alpha-methylacyl-CoA racemase