Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina, USA.
Department of Urology, Tufts University School of Medicine, Boston, Massachusetts, USA.
Can J Urol. 2022 Aug;29(4):11224-11230.
Prostate-specific antigen (PSA) screening remains the mainstay for early detection of prostate cancer. Although PSA is a nonspecific prostate cancer biomarker, its specificity for high grade prostate cancer can be enhanced by pre-biopsy liquid biomarkers including the Exosome Dx Prostate IntelliScore (EPI) test. EPI is a stand-alone urine genomic test that measures 3 exosome-derived gene expression signatures without the need for digital rectal examination (DRE) or inclusion of standard of care parameters in the test algorithm. EPI has broad clinical utility as a risk stratification tool for clinically significant high grade prostate cancer in men considering diagnostic prostate biopsy (MRI-targeted and systematic biopsy). During the COVID-19 pandemic, the EPI At-Home Collection Kit was introduced and quickly became an important component of tele-urology. The EPI test has emerged as a prioritization tool for primary care referral to urologists and for prostate biopsy scheduling. EPI provides an objective and actionable genomic risk assessment tool for high grade prostate cancer and is a critical part of the informed decision-making regarding biopsy (targeted, systematic or both) in both urology and primary care practices.
前列腺特异性抗原（PSA）筛查仍然是前列腺癌早期检测的主要方法。虽然 PSA 是一种非特异性的前列腺癌生物标志物，但通过液体生物标志物（包括 Exosome Dx Prostate IntelliScore [EPI] 检测）在活检前进行检测，可以提高其对高级别前列腺癌的特异性。EPI 是一种独立的尿液基因组检测，可测量 3 个外泌体衍生的基因表达特征，无需进行数字直肠检查（DRE），也无需在检测算法中包含标准护理参数。EPI 具有广泛的临床应用价值，可作为考虑接受前列腺活检（MRI 靶向和系统活检）的男性中具有临床意义的高级别前列腺癌的风险分层工具。在 COVID-19 大流行期间，引入了 EPI 居家采集试剂盒，并迅速成为远程泌尿科的重要组成部分。EPI 检测已成为初级保健转介泌尿科医生和安排前列腺活检的优先工具。EPI 为高级别前列腺癌提供了一种客观且可操作的基因组风险评估工具，是关于活检（靶向、系统或两者）的知情决策的重要组成部分，无论是在泌尿科还是初级保健实践中。
