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June 19, 2002

α-Methylacyl Coenzyme A Racemase as a Marker for Prostate Cancer—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;287(23):3080-3081. doi:10.1001/jama.287.23.3077

In Reply: In response to Dr Jiang and colleagues, 3 independent groups have now reported that AMACR is expressed in prostate cancer.1-3 However, as we reported, some precursor lesions, such as high-grade prostatic intraepithelial neoplasia and atrophic lesions, also express AMACR. Jiang et al note that still another putative precursor lesion, adenosis, may also express AMACR. Like all putative biomarkers, AMACR may not be specific to a single disease and should be used with caution as a tool for diagnosis. For diagnostic purposes, AMACR should be used in combination with a basal cell marker, as pointed out by all 3 groups.1-3 We also have observed AMACR expression in other tumor types, including colon, breast, and melanoma.4 Therefore, AMACR appears to be a marker for early neoplastic change but requires other markers to help distinguish the tissue of origin.