ALPHA-METHYL ACYL CO-A RACEMASE EXPRESSION IN GASTRIC BIOPSIES -A 2 YEARS STUDY AT TERTIARY CARE HOSPITAL

Dr.Cigiri.Saritha; Dr.Pavani  Kommu; Dr.S.Sandhya

Volume : VII, Issue : I, January - 2018

ALPHA-METHYL ACYL CO-A RACEMASE EXPRESSION IN GASTRIC BIOPSIES -A 2 YEARS STUDY AT TERTIARY CARE HOSPITAL

Dr. Cigiri. Saritha, Dr. Pavani Kommu, Dr. S. Sandhya

Abstract :

Alpha-methylacyl-CoA racemase (AMACR) is a mitochondrial and peroxisomal enzyme involved in beta-oxidation of dietary anched-chain fatty acids and their derivatives. Recent studies showed that AMACR is expressed in several neoplasms, including prostate and colon cancer.The present study was planned to determine if AMACR can be used as a diagnostic marker in gastric adenocarcinoma similar to prostate cancer.OBJECTIVES:The main objectives of this study is to diagnose nonneoplastic and neoplastic lesions on H&E sections, to infer rate of positivity and negativity in all cases and to correlate AMACR expression with types and grades of adenocarcinoma.MATERIALS AND METHODS:The present study is a prospective study of two years from July 2015 to June 2017. A total of 62 cases (gastric biopsies) were received at the Department of Pathology, Mahathma Gandhi Memorial hospital,Warangal constituted the material for the present study.Samples were stained with H&E for morphological details and immunohistochemistry (IHC) was done to check for the expression of AMACR proteins.

Statistical analysis was done using chi square test, Spearman�s correlation coefficient and Fisher�s exact test. The p-value ≤ 0.05 was taken as critical level of significance.

RESULTS: In this study, Immunohistochemical expression of AMACR in a total of 62 cases consisting of 18 (29%)gastritis, 4(6%) dysplasias, 40 (65%)carcinomas was studied.AMACR expression is absent or grade 0 in all 18 cases of gastritis, 2/4 (50%) of dysplasia cases showed AMACR positivity.34/40 (85%) are intestinal type adenocarcinoma and (6/40)15% are signet ring/diffuse carcinoma. AMACR expression is seen in 24/34(70%) of cases of intestinal adenocarcinoma and 1/6(17%) cases of signet ring carcinoma which is statistically significant (p<0.025).CONCLUSION :The expression of AMACR in neoplastic tissue was significantly higher as compared to adjacent dysplastic or nonneoplastic tissue of stomach and its overexpression is seen in intestinal adenocarcinoma compared to signet ring type and well differentiated adenocarcinoma than poorly differentiated adenocarcinoma.