Alpha-methylacyl-CoA racemase (AMACR) Test Cost & Procedure

Definition / general

Alpha methyl CoA racemase (AMACR) is a 382 amino acid protein that is necessary for lipid metabolism and is encoded by a 1621 base pair gene on chromosome 5p13.

One of the most common indicators of prostate cancer is elevated in malignant prostate tissue but absent from benign prostate tissue.

Essential features

90% of colon and prostate adenocarcinomas exhibit cytoplasmic expression, as do many other malignancies, such as melanoma, lymphoma, and lung cancers.

P504S Terminology (antibody against AMACR)

Pathophysiology

The racemization of alpha-methyl branched carboxylic coenzyme is catalyzed by AMACR. The oxidation of acrimony acid intermediates chains fatty acids instructs the enzyme A thioesters.

One of the main substrates of AMACR, phytanic acid is abundant in red meat and dairy products and has been linked to prostate cancer.

The pharmacological activation of ibuprofen and related medications depends on AMACR.

Clinical features

Adult-onset sensory-motor neuropathy is brought on by AMACR gene mutations, which are linked to decreased enzyme activity.

Red flesh and dairy derivatives are the primary dietary ingredients of the branched-chain fatty acid substrates of AMACR, which enhanced the danger of prostate cancer in people who complete these foods repeatedly.

The D175G and M9V polymorphisms in the AMACR gene, which are known to influence the enzyme's production and may increase one's risk of developing prostate cancer

Uses by pathologists

Prostate adenocarcinoma with a significant granular cytoplasmic staining in luminal cells is diagnosed with the help of this test, however, it can also be positive in benign mimics.

Prostatic adenocarcinoma is characterized by the overexpression of AMACR in conjunction with the absence of basal cell markers (p63 or high molecular weight cytokeratin [HMWCK]).

Basal cell markers alone are demonstrated to be inferior to a triple stain cocktail using a brown chromogen for basal cell markers (both p63 and HMWCK) and a red chromogen for AMACR, which encourages the judicious use of tissue.

Prognostic factors

In various tumor forms, including gastric adenocarcinoma, hepatocellular carcinoma, gallbladder carcinoma, nasopharyngeal carcinoma, gastrointestinal stromal tumor, and myxofibrosarcoma, it has been demonstrated that high expression of AMACR may serve as a negative prognostic factor.