Jiang Z, Wu C L, Woda B A, Iczkowski K A, Chu P G, Tretiakova M S, Young R H, Weiss L M, Blute R D, Brendler C B, Krausz T, Xu J C, Rock K L, Amin M B, Yang X J
University of Massachusetts medical School, Worcester, MA, USA.
Histopathology. 2004 Sep;45(3):218-25. doi: 10.1111/j.1365-2559.2004.01930.x.
To test whether alpha-methylacyl-CoA racemase (AMACR) is a sensitive and specific marker of prostate cancer.
The expression levels of AMACR mRNA were measured by real-time polymerase chain reaction. A total of 807 prostatic specimens were further examined by immunohistochemistry specific for AMACR. Quantitative immunostaining analyses were carried out by using the ChromaVision Automated Cellular Imaging System and the Ariol SL-50 Imaging System, respectively. AMACR mRNA levels measured in prostatic adenocarcinoma were 55 times higher than those in benign prostate tissue. Of 454 cases of prostatic adenocarcinoma, 441 were positive for AMACR, while 254 of 277 cases of benign prostate were negative for AMACR. The sensitivity and specificity of AMACR immunodetection of prostatic adenocarcinomas were 97% and 92%, respectively. Both positive and negative predictive values were 95%. By automatic imaging analyses, the AMACR immunostaining intensity and percentage in prostatic adenocarcinomas were also significantly higher than those in benign prostatic tissue (105.9 versus 16.1 for intensity, 45.7% versus 0.02% and 35.03% versus 4.64% for percentage, respectively).
We have demonstrated the promising features of AMACR as a biomarker for prostate cancer in this large series and the potential to develop automated quantitative diagnostic tests.
检测α-甲基酰基辅酶A消旋酶（AMACR）是否为前列腺癌敏感且特异的标志物。
采用实时聚合酶链反应检测AMACR mRNA的表达水平。对807份前列腺标本进行AMACR特异性免疫组化进一步检测。分别使用ChromaVision自动细胞成像系统和Ariol SL - 50成像系统进行定量免疫染色分析。前列腺腺癌中检测到的AMACR mRNA水平比良性前列腺组织高55倍。在454例前列腺腺癌病例中，441例AMACR呈阳性，而在277例良性前列腺病例中，254例AMACR呈阴性。AMACR免疫检测前列腺腺癌的敏感性和特异性分别为97%和92%。阳性预测值和阴性预测值均为95%。通过自动成像分析，前列腺腺癌中AMACR免疫染色强度和百分比也显著高于良性前列腺组织（强度分别为105.9对16.1，百分比分别为45.7%对0.02%以及35.03%对4.64%）。
在这个大样本研究中，我们证实了AMACR作为前列腺癌生物标志物的良好特性以及开发自动化定量诊断检测的潜力。
