IJCEP Copyright © 2007-All rights reserved.
Int J Clin Exp Pathol 1(6), 518-523; 2008

Original Article
Alpha-Methylacyl-CoA Racemase Expression Is Upregulated in Gastric Adenocarcinoma:
A Study of 249 Cases

Camtu D. Truong, Wei Li, Wei Feng, Philip Cagle, T. Khoury, S. Alrawi,  K Xie, J Yao and Dongfeng Tan

Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA, The University of Texas Health Science
Center at Houston, Houston, TX, USA, The Methodist Hospital, Houston, TX, USA, Roswell Park Cancer Institute, Buffalo, NY, USA and
University of Florida  Health Science Center, Jacksonville, FL, USA

Received 12 March 2008; Accepted with revision 29 March 2008; Available online 10 April 2008

Abstract: Alpha-methylacyl-CoA racemase (AMACR [P504S]) is a mitochondrial and peroxisomal enzyme involved in beta-oxidation of dietary
branched-chain fatty acids and their derivatives. Recent studies showed that AMACR is expressed in several neoplasms, including prostate
and colon cancer. However, AMACR expression in gastric neoplasms has yet to be thoroughly investigated. Because AMACR overexpression in
human solid tumors is a potential target for cancer treatment, we aimed to evaluate the expression of AMACR in a large cohort of patients with
gastric adenocarcinoma. The study evaluated 249 primary gastric adenocarcinomas by immunohistochemistry. Nonneoplastic gastric tissue
samples from various sites (antrum, body, fundus, and pylorus) were also examined. The immunopositivity of each sample was graded on a
scale from 0 to 3 (0, no expression; 1, weak expression, 2, intermediate expression; 3, strong expression). We observed AMACR expression in
141 tumor cases: 44, 47, and 50 cases had weak, intermediate, and strong expression, respectively. Both intestinal and signet ring cell
adenocarcinoma cases had overexpression of AMACR, however intestinal adenocarcinoma had significantly higher expression than did signet
ring cell adenocarcinoma (p<0.05). Nonneoplastic gastric mucosa did not show AMACR expression. The results of our study demonstrate that
AMACR expression is upregulated in gastric cancer, and suggest that further prospective studies to explore the potential role of AMACR as a
therapeutic target for gastric cancer are warranted.  (IJCEP803008).

Key Words: Gastric cancer, racemase, AMACR, immunohistochemistry, tissue microarray

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Address all correspondence to: Dongfeng Tan, MD, Department of Pathology and Laboratory Medicine, Unit 85, The University of Texas M. D.
Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA. Tel: (713) 745-4977, Fax: (713) 745-1105,