Effect of heamolysis on prostate-specific antigen

Area of Science:

• Clinical Chemistry
• Biochemistry
• Urology

Background:

• Prostate-specific antigen (PSA) is a key biomarker for prostate cancer screening and management.
• Accurate PSA measurements are crucial for clinical decision-making, especially in cases with subtle changes.
• Pre-analytical variables, such as sample handling, can influence laboratory test results.

Purpose of the Study:

• To evaluate the impact of haemolysis on free PSA (fPSA) and total PSA (tPSA) measurements in routine clinical practice.
• To determine if haemolysis causes significant interference in PSA assays.

Main Methods:

• Blood samples from 39 men were collected and processed under three conditions: standard draw, gentle expulsion (simulating haemolysis), and forceful expulsion (inducing haemolysis).
• Assays were performed for fPSA, tPSA, and potassium (K+) on all three sample types.
• Statistical analysis was used to compare results across the different sample conditions.

Main Results:

• Haemolysis significantly decreased fPSA levels from 0.535 ng/mL to 0.170 ng/mL (P=0.001).
• Haemolysis significantly decreased tPSA levels from 2.493 ng/mL to 0.929 ng/mL (P=0.001).
• Potassium levels were significantly elevated in haemolysed samples, confirming the presence of haemolysis.

Conclusions:

• Haemolysis can lead to falsely decreased fPSA and tPSA values.
• This interference may result in misinterpretation of PSA test results, particularly when small increases are clinically significant.
• Careful sample handling is essential to ensure accurate PSA testing in clinical practice.