Alpha-methylacyl-CoA racemase as a marker in the differential diagnosis of metanephric adenoma Journal Article


Authors: Olgac, S.; Hutchinson, B.; Tickoo, S. K.; Reuter, V. E.
Article Title: Alpha-methylacyl-CoA racemase as a marker in the differential diagnosis of metanephric adenoma
Abstract: Metanephric adenoma (MA), a well-described renal neoplasm, usually behaves in a benign fashion. It may have areas that are morphologically similar to papillary renal cell carcinoma (RCC) type, or epithelial (tubular predominant) type Wilms' tumor. Prior immunohistochemical studies of MA have reported variable staining patterns. Alpha-methylacyl-CoA racemase (AMACR), a molecular marker for prostate carcinoma, has subsequently been found to be overexpressed in breast, colorectal and ovarian cancers, among others. Recent microarray analysis of renal tumors has shown an increase of AMACR mRNA levels in papillary RCC but not in other subtypes. We investigated the utility of immunohistochemical staining for AMACR, cytokeratin 7(CK7), CD57 and WT1 to differentiate between the above-mentioned three neoplasms. Immunohistochemical stains were performed on paraffin-embedded tissue sections from 25 papillary RCC, 10 MAs and eight Wilms' tumors. AMACR was positive in one (10%) of 10 MAs and 24 (96%) of 25 papillary RCC, while it was negative in all Wilms' tumors. CK7 was positive in 20 of 25 papillary RCCs, focally positive in one Wilms' tumor and was negative in all MAs. CD57 was positive in all six MAs that were stained, focally positive in one of 25 papillary RCC and one of eight Wilms' tumors. WT1 was positive in seven of 10 MAs, three of 25 papillary RCCs and all eight Wilms' tumors. In conclusion, diffuse and strong immunoreactivity for AMACR may be useful in differentiating papillary RCC from MA but a panel which includes AMACR, CK7 and CD57 is better in this differential diagnosis. AMACR is not helpful in differentiating MA from Wilms' tumor, but CD57 is helpful in this differential diagnosis. WT1 may be useful in separating Wilms' tumor from MA and papillary RCC but is not helpful in differentiating MA from papillary RCC. © 2006 USCAP, Inc All rights reserved.
Keywords: immunohistochemistry; controlled study; human tissue; disease marker; biological marker; protein analysis; diagnosis, differential; differential diagnosis; carcinoma, papillary; tumor markers, biological; kidney carcinoma; kidney neoplasms; tissue section; metanephric adenoma; kidney adenoma; adenoma; carcinoma, renal cell; cytokeratin 7; wt1 protein; keratins; 2 methylacyl coenzyme a racemase; keratin-7; nephroblastoma; paraffin; racemase; cd57 antigen; wt1 proteins; wilms tumor; papillary renal cell carcinoma; embedding; racemases and epimerases; wilms' tumor; antigens, cd57
Journal Title: Modern Pathology
Volume: 19
Issue: 2
ISSN: 0893-3952
Publisher: Nature Research  
Date Published: 2006-02-01
Start Page: 218
End Page: 224
Language: English
DOI: 10.1038/modpathol.3800520
PUBMED: 16424894
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 22" - "Export Date: 4 June 2012" - "CODEN: MODPE" - "Source: Scopus"
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  1. Semra Olgac
    98 Olgac
  2. Satish K Tickoo
    478 Tickoo
  3. Victor Reuter
    1223 Reuter