Expression of α-methyl coenzyme A racemase and p16 in colorectal adenoma and adenocarcinoma

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Abstract

Background

Colorectal carcinoma (CRC) is a major cause of morbidity and mortality worldwide. It is a multistep process that arises because of the cumulative effect of mutations in various proto-oncogenes and tumor-suppressor genes. New molecular markers could be investigated for their role in pathogenesis and clinical significance to provide an experimental basis for the early diagnosis, treatment, and prognosis of colorectal cancer.

Materials and methods

We investigated the expression of AMACR and p16 in 25 colorectal adenoma and 40 carcinoma cases received as paraffin blocks and as fresh specimens.

Results

AMACR was positive in all cases of colorectal adenoma and 70% of CRC, with decreased expression in the higher grades (P=0.012). There was a statistically significant relation between AMACR expression in the carcinoma cases studied and Duke’s stage, vascular invasion, and lymph node metastases. p16 expression was found in 72% of colorectal adenoma cases and 22.5% of CRC cases, with more loss of expression in the higher grades (P=0.024). There was also a statistically significant relation between p16 expression in the carcinoma cases studied and lymphovascular invasion.

Conclusion

AMACR as well as p16 were found to have a significant relation to the pathogenesis and some prognostic factors of CRC. Additional confirmatory studies are needed to establish the significance of AMACR and p16 as a prognostic marker for CRC, with a possible link between fatty diet, AMACR expression, and colon cancer development.

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