Test Code PSAU Prostate-Specific Antigen (PSA) Ultrasensitive, Serum
Useful For
As an aid in the detection of prostate cancer when used in conjunction with a digital rectal exam in men ages 50 years and older
To aid in the prognosis and management of individuals diagnosed with prostate cancer
Monitoring disease after radical prostatectomy
This test should not be used for initial prostate cancer screening.
Method Name
Electrochemiluminescent Immunoassay (ECLIA)
Reporting Name
PSA, Ultrasensitive, SSpecimen Type
SerumCollect in an SST
Ordering Guidance
Free prostate-specific antigen (PSA) can be added on within 72 hours of performing this test. Specimen must have been shipped frozen.
If both free and total PSA results are desired, order PSAFT / Prostate-Specific Antigen (PSA), Total and Free, Serum.
Additional Testing Requirements
Necessary Information
Include patient's age.
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged, and the serum aliquoted into a plastic vial within 2 hours of collection.
Specimen Minimum Volume
0.75 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Frozen (preferred) | 180 days | |
Refrigerated | 14 days | ||
Ambient | 7 days |
Reference Values
Males:
Age (years) |
PSA upper limit (ng/mL) |
<40 |
≤2.0 |
40-49 |
≤2.5 |
50-59 |
≤3.5 |
60-69 |
≤4.5 |
70-79 |
≤6.5 |
≥80 |
≤7.2 |
Females: Not applicable
Interpretation
An undetectable (<0.01 ng/mL) ultrasensitive prostate-specific antigen (USPSA) concentration after radical prostatectomy is reassuring and may aid in postoperative risk stratification of patients.
A detectable USPSA concentration (≥0.01 ng/mL) after radical prostatectomy (RP) does not necessarily translate into disease progression or recurrence. Interpretation of a detectable USPSA needs to be made in conjunction with other clinicopathologic risk factors. The cutpoint for interpretation of USPSA assays remains controversial and has ranged from 0.01 to 0.05 ng/mL. For example, in a study that included 754 men after RP, a cutpoint of 0.01 ng/mL was an independent predictor of biochemical recurrence (BCR). BCR-free survival at 5 years was 92.4% for patients with an USPSA post-RP of less than 0.01 ng/mL and 56.8% for patients with an USPSA post-RP of 0.01 ng/mL or higher.(1) In the same study a cutoff of 0.03 ng/ml also predicted BCR independent of clinicopathological factors and BCR-free survival at 5 yrs was 90.8% for patients with an USPSA post-RP of less than 0.03 ng/mL and 26.9% for patients with a PSA post-RP of greater or equal to 0.03 ng/mL.(1)
Clinical Reference
1. Sokoll LJ, Zhang Z, Chan DW, et al. Do ultrasensitive prostate specific antigen measurements have a role in predicting long-term biochemical recurrence-free survival in men after radical prostatectomy? J Urol. 2016;195(2):330-336. doi:10.1016/j.juro.2015.08.080
2. Saint Paul LP, Debruyne D, Bernard D, Mock DM, Defer GL. Pharmacokinetics and pharmacodynamics of MD1003 (high-dose biotin) in the treatment of progressive multiple sclerosis. Expert Opin Drug Metab Toxicol. 2016;12(3):324-344. doi:10.1517/17425255.2016.1136288
3. Grimsey P, Frey N, Bendig G, et al. Population pharmacokinetics of exogenous biotin and the relationship between biotin serum levels and in vitro immunoassay interference. J Pharmacokinet Pharmacodyn. 2017 Sept;2(4):247-256. doi:10.4155/ipk-2017-0013
4. Thompson IM, Valicenti RK, Albertsen P, et al. Adjuvant and salvage radiotherapy after prostatectomy: AUA/ASTRO guideline. J Urol. 2013;190(2):441-449. doi:10.1016/j.juro.2013.05.032
5. Mir MC, Li J, Klink JC, Kattan Mw, Klein EA, Stephenson A. Optimal definition of biochemical recurrence after radical prostatectomy depends on pathologic risk factors: Identifying candidates for early salvage therapy. Eur Urol. 2014;66(2):204-210. doi:10.1016/j.eururo.2013.08.022
Day(s) Performed
Monday through Saturday
Report Available
1 to 3 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
84153
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
PSAU | PSA, Ultrasensitive, S | 35741-8 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
PSAU | PSA, Ultrasensitive, S | 35741-8 |