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Clinical Chemistry 42: 637-641, 1996;
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Clinical Chemistry, Vol 42, 637-641, Copyright © 1996 by American Association for Clinical Chemistry

Large discrepancy between prostate-specific antigen results from different assays during longitudinal follow-up of a prostate cancer patient

HL Van Duijnhoven, NC Pequeriaux, JP Van Zon and MA Blankenstein
Centralized Department of Clinical Chemistry and Hematology, St. Elisabeth Hospital, Tilburg, The Netherlands.

A case is presented of a patient with stage D prostatic carcinoma, from whom a serum sample proved to be an outlier in a correlation study performed with a 2nd-generation prostate-specific antigen (PSA) assay on the Immulite system (6.4 micrograms/L) and IMx (101 micrograms/L). Clearly, the PSA result reported by Immulite was falsely low. For nine longitudinal samples, Immulite results were approximately 20-fold lower than the IMx value (range of IMx results 5-275 micrograms/L). A selection of the samples was analyzed with the ACS:180, ES-600, and IMx (all > 180 micrograms/L); Immulite, DPC Coat-A-Count IRMA, Immuno 1, AIA-pack, and Tandem-R (all <70 micrograms/L); and Immulite free PSA assay (41 micrograms/L). Gel filtration demonstrated that apart from the alpha1-antichymotrypsin (ACT) complex, no other complexes were found. However, the sample consisted of 53% free PSA (IMx). Possibly, a change of conformation of the PSA molecule resulted in a decreased binding to ACT and a reduced affinity of the antibodies used in the affected assays.


The following articles in journals at HighWire Press have cited this article:


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 Ann Clin BiochemHome page
W. Pedrosa and L. Teixeira
Interference of heterophilic antibodies with free prostate-specific antigen in the Beckman-Coulter (Unicel DxI(R)) assay, inverting the free/total prostate-specific antigen ratio
Ann Clin Biochem, July 1, 2009; 46(4): 344 - 345.
[Full Text] [PDF]

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 Clin. Chem.Home page
S. A.R. Kort, F. Martens, H. Vanpoucke, H. L. van Duijnhoven, and M. A. Blankenstein
Comparison of 6 Automated Assays for Total and Free Prostate-Specific Antigen with Special Reference to Their Reactivity toward the WHO 96/670 Reference Preparation
Clin. Chem., August 1, 2006; 52(8): 1568 - 1574.
[Abstract] [Full Text] [PDF]


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