4K PSA Total with Reflex 4K Score Build info

Synonyms

• 4K PSA TOTAL WITH REFLEX 4K SCORE
• LAB11268

Short Name

4K PSA TOTAL WITH REFLEX 4K SCORE

Procedure Master Number

LAB11268

Procedure ID

114900

Clinical Info

 High Grade (Gleason 7+) Prostate Cancer Risk Evaluation
The 4K score should only be ordered when medically reasonable for consideration of biopsy after excluding benign    cause of PSA elevation.
 
Limitation an Exclusions for the 4Kscore
Do not use this test for a patient:
  1) With a previous diagnosis of prostate cancer
  2) That has received a DRE in a previous 96 hours (4Days) before phlebotomy. A DRE performed    after phlebotomy is acceptable.
  3) That has received within the previous six (6) months 5-alpha reductase inhibitor such as (5-ARI) therapy such an Avedaart(R) (dutasteride) or Proscar (R) (finasteride).
  4)  That has undergone within the previous six (6) months any procedure or therapy to treat symptomatic BPH or any invasive, urologic procedure that many be associated with a secondary PSA elevation prior to phlebotomy.
  5)  Test is limited to patients age 45 and over.
      
  
The 4Kscore Test will not be performed with a positive biopsy result

Specimen Sources

Specimen Types

Container

Serum Seperator Tube

Collection Instructions

Container/Tube: Gold top tube
Specimen: 3 mL serum
Transport Temperature: Refrigerated- If longer then 24 hours please freeze sample.
    Specimen is also acceptable if aliquoted & frozen
 
Note:
1. Please indicate if the patient has a previous biopsy
       [] No prior biopsy      []  Negative biopsy     [] Positive biopsy
 
2.   DRE Results
     [ ] Nodule  [ ] Normal  [ ] Not Performed
3. Clinical Indication for ordering 4KScore Test:
   
 Selecting a value below confirms that the patient has two or more elevated PSA results within the past two years.    
   [  ]  45- 54 years old and total PSA >=2 ng/mL
   [  ]  55 -75 years old and total PSA >=3 ng/mL
   [  ]  >= 76 years old and total PSA >=4 ng/mL
 
 
 

Transport Instructions

Refrigerated- If longer then 24 hours please freeze sample.

Specimen Stability

24 hours Refrigerated
 7 days Frozen

Methodology

Electrochemiluminescene Immunoassay

Days Performed

TAT: 4-5 Days

Performing Laboratory

BioReference Laboratories-GenPath

CPT

84153

PDM

Only Orderable at Locations:

Results