Association of Gleason Patterns with α-Methylacyl-Coa Racemase (AMACR) Immunohistochemistry Reaction
Related Experiment Video
Updated: Jun 12, 2025
Quantitation of Protein Expression and Co-localization Using Multiplexed Immuno-histochemical Staining and Multispectral Imaging
Published on: April 8, 2016
Background:
Prostate cancer, with a reported prevalence of 35 per hundred thousand in Türkiye, ranks third among the most frequently encountered cancers worldwide. In incisional needle biopsies, it is a challenge to identify malignant glands that are very few or sometimes mixed within benign changes such as adenosis and atrophy. AMACR is a marker that is seen to have a higher expression in the malignant lesions of the prostate compared to a normal prostate. In this study, we aimed to retrospectively report the cases where we used this marker, for which we believe that it strongly supports findings of malignancy in our daily routine, and present our findings along with other findings in the literature.
Methods:
We searched prostate needle biopsy cases in which AMACR was tested as an immunohistochemistry method between July 2022 and June 2023 on the digital system of the hospital. The study included 104 cases consisting of the diagnoses of prostate adenocarcinoma and ASAP (atypical small acinar proliferation), which included 8 HGPIN cases. Patient ages were also recorded. The cases were reevaluated based on their staining grades, rated as none: 0, weak: 1, moderate: 2, and strong: 3, in addition to the areas of staining in percentages. The collected data were analyzed using the SPSS (Statistical Package for the Social Sciences) for Windows 22.0 program.
Results:
All cases were positive for AMACR, and the prevalence was 100%. The AMACR staining grades were moderate by 44.9% in Gleason pattern 3 (P3) cases and 49.1% in Gleason pattern 4 (P4) cases, whereas most Gleason pattern 5 (P5) cases had strong staining at a rate of 63.2%. Weak staining was more frequently encountered in the eight ASAP and eight HGPIN cases, whereas no strong staining was observed in any ASAP case.
Conclusions:
In the comparisons of patient ages and Gleason patterns, no significant difference was found in terms of staining grades (p > 0.05). There was a 53.6% positive correlation between P3 and P4 staining grades (p < 0.05). There was also an 86.2% positive correlation between P5 and P4 staining grades (p < 0.05).
