81542 Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score

Name of the Procedure:

Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score.

Summary

This procedure involves analyzing the gene expression of 22 specific genes in prostate cancer tissue that has been preserved using formalin and embedded in paraffin. The results, processed through an algorithm, provide a metastasis risk score, indicating the potential likelihood of cancer spreading.

Purpose

The purpose of this procedure is to assess the risk of metastasis, or spreading, of prostate cancer. This helps in tailoring personalized treatment plans and determining the aggressiveness of the disease.

Indications

• Diagnosed prostate cancer
• Determining treatment strategies
• Evaluating the need for aggressive treatment options such as surgery or radiation
• Assessing the risk for metastasis in patients with localized prostate cancer

Preparation

• No special preparation is required from the patient.
• Prior biopsy to obtain prostate tissue for analysis.
• Review of patient's medical history and current medications.

Procedure Description

1. A previously collected prostate tissue sample, preserved in formalin and embedded in paraffin, is prepared.
2. The tissue is sliced into thin sections and placed onto slides.
3. RNA is extracted from the tissue sections.
4. The extracted RNA undergoes analysis using a microarray, which measures the expression levels of 22 specific genes.
5. Data from the microarray are processed using a specialized algorithm to generate a metastasis risk score.
6. The score is then reviewed by the medical team to inform treatment decisions.

Duration

The gene expression profiling procedure itself typically takes a few hours, but the overall process from tissue preparation to results may take a few days.

Setting

The procedure is performed in a specialized laboratory equipped for molecular analysis.

Personnel

• Pathologists
• Laboratory technicians
• Oncologists

Risks and Complications

• Minimal risk as the procedure is performed on an already collected tissue sample.
• Rare risk of sample degradation, which may necessitate a repeat biopsy.

Benefits

• Helps in accurately determining the risk of metastasis.
• Assists in making informed treatment decisions.
• Potential to avoid overtreatment in low-risk patients and ensure aggressive treatment for high-risk patients.
• Results typically available within a week.

Recovery

• No physical recovery for the patient as the procedure is non-invasive.
• Follow-up appointment to discuss results and treatment plan.

Alternatives

• Prostate-specific antigen (PSA) testing, though less specific.
• Magnetic resonance imaging (MRI) for prostate cancer evaluation.
• Traditional histopathological assessment without gene profiling.
• Pros: Alternatives are less technologically complex and widely available.
• Cons: Alternatives may not provide as detailed information about metastasis risk.

Patient Experience

• As the procedure analyzes previously collected tissue, the patient will not feel any immediate discomfort.
• Waiting for results may cause anxiety, but detailed discussions with healthcare providers can alleviate concerns.
• Comfort measures focus on post-biopsy care if a new tissue sample is required.