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Acid Phosphatase


Definition


  • Acid phosphatase is a hydrolytic enzyme secreted by various cells, and it has five isoenzymes. The greatest amount per gram of tissue is found in semen (prostate); it is also detectable in bone, liver, spleen, kidney, RBCs, and platelets. The acid phosphatase test is also known as prostatic acid phosphatase (PAP), the serum acid phosphatase test, and the tartrate-resistant acid phosphatase (TRAP) test.
  • Normal range: 0 " “0.8 U/L.

Use


  • Predicts recurrence after radical prostatectomy for clinically localized prostate cancer and following response to androgen ablation therapy, when used in conjunction with PSA

Interpretation


Increased In


  • Acid phosphatase is increased in the following conditions:
    • Prostate cancer
    • Gaucher disease and Niemann-Pick disease
    • One day to 2 days after prostatic surgery or biopsy
    • Prostatic manipulation or catheterization
    • Benign prostatic hyperplasia, prostatitis, prostate infarct
    • Vaginal swabs from rape victims.

Limitations


  • PAP is no longer used to screen for or to stage prostate cancer. In most instances, serum PSA is used instead.
  • PAP measurement must not be regarded as an absolute test for malignancy, since other factors including benign prostatic hyperplasia, prostatic infarction, and manipulation of the prostate gland may result in elevated serum PAP concentrations.
  • PAP measurements provide little additional information beyond that provided by PSA measurements.

Suggested Reading


1Moul ‚  JW, Connelly ‚  RR, Perahia ‚  B, et al. The contemporary value of pretreatment prostatic acid phosphatase to predict pathological stage and recurrence in radical prostatectomy cases. J Urol.  1998;159:935 " “940.
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