ALPHA-METHYLACL-COA RACEMASE (AMACR) EXPRESSION IN PROSTATE CANCER AND ITS ASSOCIATION WITH GLEASON GRADE & OTHER HISTOMORPHOLOGICAL PARAMETERS: AN IMMUNOHISTOCHEMICALLY ANALYSIS
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Keywords
Prostate cancer, malignancies, worldwide, morbidity and mortality
Abstract
Prostate cancer remains one of the most prevalent malignancies affecting men worldwide, with a significant impact on morbidity and mortality.
Objectives: The main objective of the study is to find the Alpha-Methylacl-CoA Racemase (AMACR) expression in prostate cancer and its association with Gleason Grade and other histomorphological parameters.
Material and Methods: This retrospective observational study was conducted at Women Medical College, Abbottabad from January 2022 to February 2023. Data was collected from 110 patients diagnosed with prostate cancer. Clinical and pathological data including patient demographics, preoperative serum prostate-specific antigen (PSA) levels, imaging findings, biopsy results, and surgical pathology reports were collected from electronic medical records. Formalin-fixed paraffin-embedded (FFPE) tissue blocks from prostatectomy specimens or biopsy cores was retrieved from the pathology archives. Tissue sections (4-μm thick) were cut and subjected to immunohistochemical staining for AMACR expression using a commercially available antibody according to standard protocols. Positive and negative controls were included in each staining batch to ensure accuracy and reproducibility.
Results: Data were collected from 110 patients according to inclusion and exclusion criteria. Patients with a mean age of 65.4 years (± 7.2), presenting with preoperative PSA levels averaging 9.8 ng/mL (± 4.3). Most patients underwent MRI imaging (70%), while the remaining 30% underwent TRUS imaging. Biopsy results indicated a predominance of positive cases (105), with only 5 cases negative for prostate cancer. Gleason scores varied, with 30 cases classified as 6 (3+3), 50 as 7 (3+4), 20 as 7 (4+3), and 10 as 8-10. Patients with Gleason score 6 had a mean PSA level of 7.5 ng/mL (± 3.1) and a mean AMACR level of 0.45 (± 0.06). In contrast, patients with Gleason score 7 had a higher mean PSA level of 10.2 ng/mL (± 4.7) and a correspondingly higher mean AMACR level of 0.58 (± 0.09). Patients with more aggressive disease, classified as Gleason score 8-10, exhibited the highest mean PSA level of 12.4 ng/mL (± 5.6), accompanied by a higher mean AMACR level of 0.65 (± 0.11).
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Bayyanah Batool
PhD. Scholar, Institute of Medical Lab Technology, University of Lahore, Pakistan
Dr. Sadaf Shaheen
Associate Professor Anatomy, Women Medical College, Abbottabad Pakistan
Dr. Abdul Sattar Khan
MBBS, M.Phil Biochemistry, Liaquat University of Medical and Health Sciences Jamshoro Pakistan
Dr. Nadia Younus
Associate Professor Anatomy, Jinnah Medical and Dental College, Karachi Pakistan
Dr. Masooma Talib
Associate Professor Biochemistry, Watim Medical and Dental College, Rawalpindi Pakistan
Dr. Iqra Anwar
Assistant Professor Biochemistry, Watim Medical and Dental College, Rawalpindi Pakistan
Dr. Abeerah Zainub
Assistant Professor Biochemistry, Islamic International Medical College, Rawalpindi Pakistan