World Journal of Urology

, Volume 31, Issue 4, pp 847–853

Prognostic value of alpha-methyl CoA racemase (AMACR) expression in renal cell carcinoma

  • Christian Eichelberg
  • Sarah Minner
  • Hendrik Isbarn
  • Eike Burandt
  • Luigi Terracciano
  • Holger Moch
  • Alexandra Kell
  • Roman Heuer
  • Felix K. Chun
  • Guido Sauter
  • Margit Fisch
  • Pierre Tennstedt
Original Article

DOI: 10.1007/s00345-011-0783-z

Cite this article as:
Eichelberg, C., Minner, S., Isbarn, H. et al. World J Urol (2013) 31: 847. doi:10.1007/s00345-011-0783-z

Abstract

Purpose

Alpha-methyl CoA racemase (AMACR) is used as an immunohistochemical marker for renal cell carcinoma (RCC) subtyping to distinguish papillary (pap) RCC. Expression of AMACR in other renal tumor subtypes is inhomogeneous, and the clinical and prognostic value of AMACR is unknown. The aim of this study was to asses AMACR protein expression in different RCC subtypes and to investigate its prognostic significance.

Methods

Protein expression of AMACR was analyzed in 1,088 renal tumor samples, among them 809 clear cell RCC and 151 papRCC, by immunohistochemistry using tissue microarry (TMA) technique. Results were correlated with clinicopathological data and to follow-up data [overall (OS)/cancer-specific survival (CSS)].

Results

Frequency of AMACR expression was significantly higher in papRCC compared to other tumor subtypes (83% vs. 15–35%, p < 0.0001). Presence of AMACR did not correlate with stage or nodal metastases in papRCC. In a dichotomized scoring (negative vs. positive expression), an inverse correlation between higher grade (p = 0.03) and presence of distant metastasis (p = 0.014) was observed in papRCC. AMACR expression correlated with the presence of nodal metastasis in ccRCC (p = 0.02). Both in ccRCC and in papRCC, OS and CSS did not correlate with the AMACR expression status.

Conclusions

The high expression in papRCC confirms AMACR to be a marker for subtype differentiation in RCC, while a missing expression in this subtype seems to be associated with negative pathological features. However, in contrast to other tumor entities, AMACR expression seems to have a limited prognostic impact in renal carcinoma, especially with regard to survival.

Keywords

Renal carcinoma subtyping Alpha-methyl CoA racemase (AMACR) P504 s Prognosis Papillary renal carcinoma 

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Christian Eichelberg
    • 1
  • Sarah Minner
    • 2
  • Hendrik Isbarn
    • 1
  • Eike Burandt
    • 2
  • Luigi Terracciano
    • 3
  • Holger Moch
    • 4
  • Alexandra Kell
    • 1
  • Roman Heuer
    • 1
  • Felix K. Chun
    • 1
  • Guido Sauter
    • 2
  • Margit Fisch
    • 1
  • Pierre Tennstedt
    • 2
  1. 1.Department of UrologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Institute of PathologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  3. 3.Department of Molecular PathologyUniversity Hospital BaselBaselSwitzerland
  4. 4.Institute for Surgical PathologyUniversity Hospital ZurichZürichSwitzerland

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