title: Expression of Alpha Methylacyl CoA Racemase (AMACR) in Gastric Adenocarcinoma and Its Correlation withHelicobacter pyloriInfection.
abstract: BACKGROUND
  Gastric cancer develops in a multistep progression and is determined by genetic and environmental factors. Over-expression of Alpha Methylacyl CoA Racemase (AMACR) is useful in diagnosis of prostate cancer. There is plenty of genetic alteration that occurs in gastric adenocarcinoma. The present study was planned to determine if AMACR can be used as a diagnostic marker in gastric adenocarcinoma similar to prostate cancer.
  
  
  OBJECTIVE
  To study the expression of AMACR in gastric adenocarcinoma and correlate its expression with density ofHelicobacter pylori.
  
  
  METHODS
  This cross-sectional, prospective study was conducted from August 2013-2015. Fifty gastric cancer biopsies were taken. Adjacent biopsy from normal/reactive mucosa was also taken from 21 cases. Samples were stained with H&E for morphological details, Loeffler's methylene blue forHelicobacter pyloriand immunohistochemistry (IHC) was done to check for the expression of AMACR proteins. Statistical analysis was done using chi square test, Spearman's correlation coefficient and Fisher's exact test. The p-value ≤ 0.05 was taken as critical level of significance.
  
  
  RESULTS
  Overexpression of AMACR was observed in 88.89% of intestinal type and 78.05% of diffuse type adenocarcinoma. AMACR expression was significantly less in adjacent reactive/dysplastic mucosa.Helicobacter pyloriwere seen in 8/9 (88.89%) and 35/41(85.36%) cases of intestinal adenocarcinoma and diffuse adenocarcinoma respectively. When grades ofHelicobacter pyloriwere compared with the positivity of AMACR, no significant association and correlation was found.
  
  
  CONCLUSIONS
  The expression of AMACR in neoplastic tissue was significantly higher as compared to adjacent dysplastic, reactive or normal tissue. Thus, IHC for AMACR can be used for differentiating the cases of reactive atypia from early neoplastic lesions similar to its role in prostatic tissue.Helicobacter pyloridoes not affect the expression of AMACR in neoplastic gastric lesions.
authors.affiliation: Junior Resident, Department of Pathology, M.L.N. Medical College , Allahabad, U.P., India .
authors.forename: Yamini
authors.initials: Y
authors.lastname: Jindal
authors.affiliation: Assistant Professor, Department Pathology, M.L.N. Medical College , Allahabad, U.P., India .
authors.forename: Anshul
authors.initials: A
authors.lastname: Singh
authors.affiliation: Senior Resident, Department of Gastroenterology M.L.N. Medical College , Allahabad, U.P., India .
authors.forename: Ravikant
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Associate Professor, Department of Pathology, M.L.N. Medical College , Allahabad, U.P., India .
authors.forename: Kachnar
authors.initials: K
authors.lastname: Varma
authors.affiliation: Professor and Head, Department of Pathology, M.L.N. Medical College , Allahabad, U.P., India .
authors.forename: Vatsala
authors.initials: V
authors.lastname: Misra
authors.affiliation: Professor and Head, Department of Gastrology, M.L.N. Medical College , Allahabad, U.P., India .
authors.forename: Sri Prakash
authors.initials: SP
authors.lastname: Misra
authors.affiliation: Professor, Department of Gastrology, M.L.N. Medical College , Allahabad, U.P., India .
authors.forename: Manisha
authors.initials: M
authors.lastname: Dwivedi
keywords: Diffuse type adenocarcinoma; Immunohistochemistry; Intestinal type adenocarcinoma