PSA and acid phosphatase in the diagnosis of prostate cancer

T. Ming Chu, Ming Fong Lin

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Prostate specific antigen (PSA) and prostate acid phosphatase (PAP) are two well known markers for prostate cancer. PSA was isolated in 1979 and is biochemically a 33-kDa serine protease and in isomeric form. The PSA blood test was developed in 1980 and has been most useful in the staging, monitoring, and early detection of recurrent disease. PSA is of greatest value as a screening aid for the early detection of prostate cancer. Early- stage, organ-confined, nonpalpable, and clinically significant, but curable prostate tumors, have been detected by PSA and digital rectal examination. Several derivative PSA tests, such as PSA velocity or slope, PSA density or index, age-specific referenced PSA ranges, and free versus complexed PSA have been examined to improve the diagnostic accuracy of PSA. Age- and race- specific PSA ranges and free PSA appear to enhance the ability of PSA to differentiate prostate cancer from benign prostatic hypertrophy, but large statistically valid trials are still needed. The PSA immunohistochemical test was developed in 1981 to detect secondary metastasis of prostate carcinoma. Detection of micrometastasis also has been improved by reverse transcriptase (RT)polymerase chain reaction (PCR) of PSA-containing prostate cells in circulation, bone marrow, and lymph nodes. RT-PCR is still an experimental tool at present. Prostate acid phosphatase (PAP) is the old 'gold standard' for prostate cancer. Overall, PSA is a better disease parameter than PAP. However, recent investigations on the basic biochemistry and molecular biology of PAP have provided new insight into its potential role in the diagnosis and therapeutic monitoring of prostate cancer.

Original languageEnglish (US)
Pages (from-to)24-34
Number of pages11
JournalJournal of Clinical Ligand Assay
Issue number1
StatePublished - Mar 1998


  • Acid phosphatase
  • Diagnosis
  • Early detection
  • Prostate cancer
  • Prostate specific antigen
  • Screening

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical


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