MyProstateScore (MPS; previously MiPS) is an early detection test for prostate cancer that incorporates three specific markers, TMPRSS2:ERG (T2:ERG) gene fusion, PCA3 (prostate cancer antigen-3), and PSA (prostate-specific antigen). Two genes, TMPRSS2:ERG and PCA3 are specific for prostate cancer, they are rarely present at high levels in the urine of men without prostate cancer. The MPS test was developed by measuring serum PSA, urine T2:ERG, and urine PCA3 in men immediately before prostate biopsy. Models were then generated that optimally combine these three biomarkers to predict the presence of prostate cancer or high-grade cancer, on biopsy. The MPS test was developed and validated on almost 2,000 patients. MPS is designed to help doctors and patients make a decision after PSA testing about whether to monitor PSA levels or pursue a prostate biopsy. Click here for more information.
PCA3 (prostate cancer antigen-3) is a gene that is found in the prostate whose expression level (mRNA) is increased in cancer. The PCA3 test measures the level of the PCA3 mRNA in the first urine collected following an attentive digital rectal examination, with higher levels being potentially associated with a positive prostate cancer biopsy as determined by a calculated score. PCA-3 may help to improve the specificity of prostate cancer detection providing additional information about the risk of prostate cancer over the use of the PSA test alone. The combined measurement of PSA and PCA3 could help in determining if performing a biopsy would be helpful for the patient. The PCA3 test alone is not presently indicated to be used as a screening test for prostate cancer. The Molecular Testing lab at MCTP, in association with the University of Michigan MLabs, is now offering PCA3 testing to supplement PSA testing upon physician request.
Physicians may be interested in reading the following research papers related to this topic:
- Prevalance of prostate cancer among men with a prostate-specific antigen level < or= 4.0 ng per milliliter. Thompson, I.M., et al., N England Journal of Medicine, 2004, May 27;350:(22) 2239-2246. Erratum in: N Engl J Med 2004 Sep 30;35(14):1470 PMID 15163773
- Rational approach to implementation of prostate cancer antigen 3 into clinical care. Wang, R., et al, Cancer, 2009, Sep 1; 115 (17):3879-86. PMID 19517474
The CellSearch® CTC Test is the first diagnostic test used to automate the capture and detection of circulating tumor cells (CTCs), tumor cells that have detached from solid tumors and entered the patient’s blood. The CellSearch® CTC Test represents an important shift in the management of metastatic breast, colorectal, or prostate cancer patients as an adjunct to standard methods of monitoring disease status and to provide a more complete picture of patient prognosis. CellSearch® result is intended for use in conjunction with all clinical information derived from diagnostic tests (e.g., imaging, laboratory tests), physical examination, and complete medical history in accordance with appropriate patient management procedures.
ERG FISH clinical assay
ERG gene rearrangements are present in a subset of prostate cancers and detection of such rearrangements can aid in the classification and diagnosis of prostatic adenocarcinoma. A clinical FISH assay to detect ERG rearrangements has been developed under the GU Service line initiative and is now available for use to assist in the diagnosis of neuroendocrine prostate cancer, in the differential diagnosis of poorly differentiated prostate cancer from poorly differentiated urothelial cancer, and diagnosis of metastatic ERG positive prostate cancer (especially treated prostate cancer where ERG protein expression might be absent or equivocal). For further details of this assay, click here.
Other GU Service Line Tests (MLabs)
To order tests, physicians may contact either the Molecular Testing Lab at MCTP or MLabs at the University of Michigan:
- Molecular Testing Lab at MCTP: (734) 232-0834.
- MLabs for information on specimen procurement and handling:
MLabs Clinic location:
1500 East Medical Center Drive
Floor 2, Room 2F367, Reception: Pathology-Central Distribution
Ann Arbor, MI 48109-5054