ACAT1 and prostate cancer progression

This study evaluated the efficacy of Acetyl-Coenzyme A acetyltransferase 1 (ACAT1) as a biomarker of prostate cancer progression.

Biomarkers or biological molecules used as clinical indicators have continued to impact prostate cancer management in terms of disease diagnosis and prognosis. Prostate cancer biomarkers help in evaluating the risks of developing the disease, identifying the aggressiveness of diagnosed disease and can provide direction for individualized treatment options. Of particular interest in prostate cancer is the use of prognostic biomarkers, which can identify the course or outcome of a cancer.

The most widely-used biomarker for prostate cancer is prostate-specific antigen (PSA). However, this biomarker is not very specific, and cannot distinguish between those patients with an aggressive form of the disease and those with slowly developing tumors. Acetyl-Coenzyme A acetyltransferase 1 has been identified as one of the key enzymes highly elevated during prostate cancer progression. This study aimed to evaluate the diagnostic and prognostic potential of ACAT1 as a prostate cancer biomarker. 

This study included 251 patients with localized (has not spread beyond the prostate gland) cancer who underwent radical prostatectomy (a surgical removal of all or part of the prostate gland).

Expression of ACAT1 was significantly elevated in cancerous tissues compared to benign (non-cancerous) tissues. In the usual cancer grading systems whereby the tumor cells are characterized by their appearance under a microscope, high-grade tumors are associated with a poorer prognosis and low-grade tumors are associated with a better prognosis. This study found ACAT1 expression to be elevated in high-grade prostate cancer tumors compared to low and intermediate grade tumors. In addition, those tumors that were confined to the prostate had a significantly lower expression of ACAT1 compared to tumors that had extended beyond the prostate.

The length of time patients retained stable prostate-specific antigen levels after cancer therapy (biochemical progression-free survival) was significantly shorter in patients with high ACAT1 expression. Further, high expression of ACAT1 was associated with shorter disease-free survival (period after successful treatment in which there is no appearance of the symptoms or effects of the disease).

In summary, this study concluded that acetyl-coenzyme A acetyltransferase 1 could potentially serve as an independent prognostic biomarker in prostate cancer, particularly in differentiating aggressive forms of the cancer.

This study was conducted in Toronto, and so studies should be completed on a broader scale to ensure the associations are similar in the general population.