Fast Five Quiz: Prostate Cancer Molecular and Biomarker Analysis

Chad R. Tracy, MD


August 11, 2023

Prostate health index combines three PSA isoforms in the blood (proPSA, freePSA, and total PSA) to create a composite score that predicts the likelihood of PCa on biopsy. It is FDA-approved and is included in the NCCN diagnostic guidelines for PCa workup.

Select MDX combines clinical parameters of messenger RNA (mRNA) expression levels of DLX1 and HOXC6 to estimate the likelihood of PCa and Gleason score > 7 on biopsy. It is not FDA-approved but is included in the NCCN guidelines. The test is performed on post-digital rectal examination (DRE) urine.

ExoDx prostate intelliscore measures urinary exosomal mRNA of PCA3 and ERG normalized with SPDEF on a scale of 0-100. It does not require a DRE prior to urine collection and does not incorporate any clinical variables as part of the score. This test is also not FDA-approved but is part of the NCCN guidelines.

MyProstateScore (MPS) requires a post-DRE urine specimen and combines urinary PCA3 and TMPRSS2:ERG fusion gene expression with PSA to provide a score that ranges from 0 to 100. Scores increase with the likelihood of detecting Gleason ⩾ 7 PCa and are grouped into low, intermediate, or high risk. MPS is used as a tool to guide biopsy decisions and is found to be more cost-effective than MRI or ordering biopsies for all patients with indeterminate PSA levels.

Learn more about screening for PCa.


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