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PSA Total
Test CodePSAT
Alias/See Also
PSA, Prostatic Antigen, Prostate-Specific Antigen, TPSA, PSA Total, Prostatic Specific Antigen
Preferred Specimen
1.0 mL plasma (0.5 mL minimum)
Transport Container
PST (light green top). Red top and SST also acceptable
Specimen Stability
Room temperature: 8 hours, Refrigerated: 24 hours, Frozen: 7 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Grossly hemolyzed specimens are unacceptable.
Report Available
24 hours
Limitations
An erroneously elevated PSA Total level can be observed if the serum specimen from a patient is collected following digital rectal examination, needle biopsy or transurethral resection.
Reference Range
< 4.0 ng/mL
Clinical Significance
The level of PSA in serum and other tissues is normally very low. In malignant prostate disease (prostatic adenocarcinoma) and in non-malignant disorders such as benign prostate hypertrophy (BPH) and prostatitis, the serum level of PSA may become elevated.
In serum PSA exists primarily as three forms: free and complexed with either a1-antichymotrypsin (ACT) or a2-macroglobulin. The PSA protein associated with a2-macroglobulin is encapsulated and unavailable for measurement by current immunoassay systems. The TPSA assay on the Dimension Vista System measures both the free and the ACT bound components of serum PSA equally, a property known as equimolarity.
The specificity of PSA to prostate tissue makes it a significant marker as an aid to the early detection and management of prostate diseases.
Prostate cancer is the most common type of cancer found in men in the United States and the second leading cause of male cancer mortality. Prior to the use of PSA for early detection of prostate cancer, the traditional method of digital rectal examination (DRE) detected considerably fewer tumors. The most sensitive method for early detection of prostate cancer uses both DRE and PSA. The American Cancer Society and the American Urological Association (AUA) recommend that early detection of prostate cancer should be offered to asymptomatic men 50 years of age or older with an estimated life expectancy of more than 10 years. An abnormal DRE and/or an elevated PSA may suggest the presence of prostate cancer; however a prostate biopsy is required for final diagnosis. PSA testing is also accepted as an adjunctive test in the management of prostate cancer. Serum levels of
PSA are most useful when sequential values are obtained and monitored over time. After complete removal of the prostate gland (radical prostatectomy), PSA levels should decline to a very low or non-detectable level. A rise of the serum PSA level in prostatectomy patients indicates residual prostate tissue; recurrence or metastasis of the disease. Serum PSA levels during radiation treatment should decline and remain at baseline while the patient is in remission.
In serum PSA exists primarily as three forms: free and complexed with either a1-antichymotrypsin (ACT) or a2-macroglobulin. The PSA protein associated with a2-macroglobulin is encapsulated and unavailable for measurement by current immunoassay systems. The TPSA assay on the Dimension Vista System measures both the free and the ACT bound components of serum PSA equally, a property known as equimolarity.
The specificity of PSA to prostate tissue makes it a significant marker as an aid to the early detection and management of prostate diseases.
Prostate cancer is the most common type of cancer found in men in the United States and the second leading cause of male cancer mortality. Prior to the use of PSA for early detection of prostate cancer, the traditional method of digital rectal examination (DRE) detected considerably fewer tumors. The most sensitive method for early detection of prostate cancer uses both DRE and PSA. The American Cancer Society and the American Urological Association (AUA) recommend that early detection of prostate cancer should be offered to asymptomatic men 50 years of age or older with an estimated life expectancy of more than 10 years. An abnormal DRE and/or an elevated PSA may suggest the presence of prostate cancer; however a prostate biopsy is required for final diagnosis. PSA testing is also accepted as an adjunctive test in the management of prostate cancer. Serum levels of
PSA are most useful when sequential values are obtained and monitored over time. After complete removal of the prostate gland (radical prostatectomy), PSA levels should decline to a very low or non-detectable level. A rise of the serum PSA level in prostatectomy patients indicates residual prostate tissue; recurrence or metastasis of the disease. Serum PSA levels during radiation treatment should decline and remain at baseline while the patient is in remission.
