A-Methylacyl-CoA Racemase (AMACR) and Prostate-Cancer Risk: A Meta-Analysis of 4,385 Participants

BACKGROUND Alpha-methylacyl-CoA racemase (AMACR) is a mitochondrial and peroxisomal enzyme that is overexpressed in prostate cancer. The aim of this study was to confirm and expand the findings that the PCa risk increased in men associated with AMACR expression across various geographic regions. METHODS A systematic search of databases was carried out and other relevant articles were also identified. Then the meta-analyses were conducted according to the standard guidelines. RESULTS A total of 22 studies with 4,385 participants were included on the basis of inclusion criteria. AMACR by IHC was significantly associated with increased diagnosis of PCa (OR = 76.08; 95% CI, 25.53-226.68; P<0.00001). Subgroup-analysis showed that findings didn't substantially change when only Caucasians or Asians (OR = 51.23; 95% CI, 19.41-135.24; P<0.00001) were considered. Expression of AMACR by PCR in relation to PCa risk suggested that AMACR was associated with PCa (OR = 33.60; 95% CI, 4.67-241.77; P<0.00001). There was also no significant publication bias observed. CONCLUSIONS Our findings provide further evidences that the expression of AMACR contribute to PCa risk. AMACR protein overexpression was found in prostate cancers, low expression in any of the normal tissues or in benign prostatic tissue. AMACR is potentially an important prostate tumor marker.