Test Code 0212902 Prostate Specific Antigen (PSA), Total and Free, Serum
Methodology
Chemiluminescent microparticle immunoassay (CMIA)
Performing Laboratory
Alomere Health Hospital Laboratory
Specimen Requirements
Specimen Type: Serum only
Collection Container/Tube: Gold (gel separator) or Red (plain)
Specimen Volume: 2.0 mL
Specimen Minimum Volume: 0.2 mL
Collection Instructions:
1. Allow serum tubes to clot completely. This may take up to 30 minutes.
2. Remove sample from cells by pipetting.
Reject Due To:
Plasma submitted
Specimen Transport Temperature
For Free PSA - Centrifuge and separate off cells within 3 hours
Within 48 hours: Refrigerated (when centrifuged and separated off cells)
>48 hours: Frozen
Reference Values
The total PSA range of 4.0 to 10.0 ng/mL has been described as a diagnostic "gray zone," in which the free PSA:total PSA ratio helps to determine the relative risk of prostate cancer (see table). Therefore, some urologists recommend using the free PSA:total ratio to help select which men should undergo biopsy. However, even a negative result of prostate biopsy does not rule-out prostate cancer. Up to 20% of men with negative biopsy results have subsequently been found to have cancer.
Our reference laboratory, Mayo Medical Laboratories, uses the following criteria:
Based on free PSA:total PSA ratio: the percent probability of finding prostate cancer on a needle biopsy by age in years:
Free PSA:total PSA ratio |
50-59 years |
60-69 years |
70 years and older |
≤0.10 |
49% |
58% |
65% |
0.11-0.18 |
27% |
34% |
41% |
0.19-0.25 |
18% |
24% |
30% |
>0.25 |
9% |
12% |
16% |
This testing method is a chemiluminescent microparticle immunoassay (CMIA) using the Alinity PSA Free and PSA Total assays.
Values obtained with different assay methods or kits may be different and cannot be used interchangeably. Test results cannot be interpreted as absolute evidence for the presence or absence of malignant disease.
Day(s) Test Set Up
Monday through Friday
Test Classification and CPT Coding
84153 - PSA. Total
84154 - PSA, Free