Prostate-Specific Antigen (PSA), Total
Order Code: PSA
Order Form: Laboratory Requisition
Specimen(s):
Plasma
Collection Medium:
Plasma Separator Tube
Alternate Collection Media:
Call laboratory for additional acceptable specimen collection containers.
Minimum:
3 mL whole blood in light green top tube or TWO microtainers.
Testing Schedule:
24 hrs/day, 7 days a week, including holidays.
Turn Around Time:
1 hour (upon receipt in laboratory)
Reference Range:
Age Reference Range Up to 50 0.00-2.50 ng/mL 50 - 59 0.00-3.50 ng/mL 60 - 69 0.00-4.50 ng/mL > 70 0.00-6.50 ng/mL Age specific normal values from the literature for PSA are provided as a guide only. No one decision level is appropriate when utilizing PSA in screening situation. Age, family history, previous values, and other factors should be used in decisions involving PSA values.
Comments:
Prostate-Specific Antigen (PSA) measurement used in conjunction with Digital Rectal Exam (DRE) is indicated as an aid for the detection of prostate cancer in men aged 50 years or older. It is also useful in monitoring patients with known prostate cancer. PSA is specific to the prostate gland and is present in normal, hyperplastic and neoplastic prostatic epithelium. Serum elevations are detected in not only prostate carcinoma, but also in benign prostatic hypertrophy and inflammatory conditions of the prostate and adjacent genitourinary tissues. Diagnosis of prostate cancer requires biopsy and histopathologic examination.

Please print, complete and submit the Advance Beneficiary Notice (ABN) along with the Laboratory Requisition before shipping the specimen.

Effective 12-31-99, changed Total PSA method. New immunoassay is equimolar and gives results slightly lower than Hybritech immunoassay.
Test Limitations:
The assay is unaffected by icterus (bilirubin < 65 mg/dL), hemolysis (Hb is less than 2200 mg/dL), lipemia (Intralipid is less than 1500 mg/dL) and biotin is less than 60 ng/mL (criterion: recovery within plus or minus 10% of initial value). In patients receiving therapy with high biotin doses (i.e. is greater than 5 mg/day) no sample should be taken until at least 8 hours after the last biotin administration. No interference was observed from rheumatoid factor (up to 1,500 U/mL). There is no high-dose hook effect at tPSA concentrations up to 17,000 ng/mL. In vitro tests were performed on 28 commonly used pharmaceuticals. No interference with the assay was found. As with all tests containing monoclonal mouse antibodies, erroneous findings may be obtained from samples taken from patients who have been treated with monoclonal mouse antibodies or have received them for diagnostic purposes. Elecsys total PSA contains additives which minimize these effects. In rare cases, interference due to extremely high titers of antibodies to streptavidin can occur. It is known that in rare cases PSA isoforms do exist which may be measured differently by different PSA tests. Findings of this kind have occasionally been reported for PSA tests from various manufacturers.(1-3) For diagnostic purposes, the total PSA findings should always be assessed in conjunction with the patient's medical history, clinical examination and other findings. (1) Van Duijnhoven HLP, Perqueriauz NCV, van Zon JPHM, Blankenstein MA. Large discrepancy between prostate specific antigen results from different assays during longitudinal followup of a prostate cancer patient. Clin Chem 1996;42:637-641. (2) Wians FH. The "Correct" PSA Concentration. Clin Chem 1996;42:1882-1885 (3) Cohen RJ, Haffejee Z, Steele GS, Nayler SJ. Advanced Prostate Cancer With Normal Serum Prostate-Specific Antigen Values. Arch Pathol Lab Med 1994;118:1123-1126.
Methodology:
Electrochemiluminescence Immunoassay
Sample Processing:
Centrifuge at 3000 RPM for 10 minutes.
Aliquot plasma into labeled container and cap.
Sample Storage:
Refrigerate.
Transport Instructions:
Place specimen into zip-lock type bag, seal bag.
Place requisition into outside pocket of bag.
Transport in cooler with refrigerated coolant packs.
CPT Code:
84153