[Histonet] AMACR (P504S)

[RSRICHMOND <@t> aol.com]

Michele Marggi, Surgical Pathology Supervisor, St. Marys Hospital Medical 
Center, Madison, Wisconsin asks:

>>I am researching AMACR (P504s) and need some help. Who out there in 
histo-land is using it? Is this a Research Use Only antibody? Is a disclaimer in the 
report required?<<

P504S = AMACR, alpha-methylacyl-CoA racemase. An immunostain for AMACR is 
supposed to mark prostate cancer and not benign glands - also marks many 
urothelial cancers. Jonathan Epstein, the prostate guru at Johns Hopkins, recommends 
it. He notes that while all prostate cancers processed at Johns Hopkins mark 
with it, that 30% of prostate cancers processed elsewhere don't. Clearly some 
processing problems need to be researched.

Our group of five pathologists introduced it a year or so ago. We haven't 
been too impressed with it (though we find the 34BE12 IHC for prostate basal cell 
high molecular weight cytokeratin to be essential in maybe 10% of cases). 

I'm not aware of any special disclaimer needed in a report. Like any "special 
stain for cancer" it's dangerous in the hands of anybody but an experienced 
pathologist!

Bob Richmond
Gastonia NC