title: Comparison between prostate specific antigen and acid phosphatase for detection of semen in vaginal swabs from raped women.
abstract: OBJECTIVE
  To compare the effectiveness of the prostate specific antigen (PSA) test and the acid phosphatase (AP) test for semen detection in human vaginal samples.
  
  
  METHODS
  The source materials were vaginal swabs that were tested at Ramathibodi Hospital between 2008 and 2010 from 2450 cases of raped women. Each swab was tested for semen by three methods: sperm detection by light microscopy, the AP enzymatic reaction, and the presence of PSA by using an immuno-chromatographic rapid kit test. The efficiencies of the AP and PSA tests were compared using the light microscopy result for the presence of sperm as the gold standard.
  
  
  RESULTS
  The specificities of the AP, the PSA and the combined AP-PSA tests were 96.4%, 92.3% and 91.9%, respectively, and the sensitivities were 65.5%, 80.4% and 84.5%, respectively. The receiver operating characteristic (ROC) area of the AP, PSA and combined AP-PSA tests were 0.8091, 0.8639 and 0.8823, respectively. The ROC area of the PSA test was significantly greater than that of the AP test (p < 0.0001), and the ROC area of the combined AP-PSA test was significantly greater than both the tests individually (p < 0.0001).
  
  
  CONCLUSIONS
  Based on the ROC area, the PSA test was better than the AP test for semen detection in the vaginal swabs, and the combined results (AP + PSA) were better than the individual tests. The specificity of the AP test was higher than the PSA test in this study because a positive detection was made within only 15 s. While the PSA test was more convenient as it was available in a rapid test kit format, our recommendation is PSA detection should be done together with AP test and spermatozoa examination to identify evidence of rape.
  
  
  CONCLUSIONS
  Using these three tests together (AP, PSA, and spermatozoa detection) was recommended as a forensic tool for investigations of vaginal swabs of the rape victims.
authors.affiliation: Division of Forensic Medicine, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand.
authors.forename: Vichan
authors.initials: V
authors.lastname: Peonim
authors.forename: Wisarn
authors.initials: W
authors.lastname: Worasuwannarak
authors.forename: Kanchana
authors.initials: K
authors.lastname: Sujirachato
authors.forename: Somsri
authors.initials: S
authors.lastname: Teerakamchai
authors.forename: Smith
authors.initials: S
authors.lastname: Srisont
authors.forename: Jitta
authors.initials: J
authors.lastname: Udnoon
authors.forename: Ubon
authors.initials: U
authors.lastname: Chudoung
mesh_terms: D000135:Acid Phosphatase / Q000032:analysis*; D002582:Cervix Mucus / Q000737:chemistry*; D002846:Chromatography, Affinity; D005260:Female; D005554:Forensic Medicine / Q000379:methods; D006801:Humans; D008297:Male; D008853:Microscopy; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000032:analysis*; D012372:ROC Curve; D011902:Rape; D012661:Semen / Q000737:chemistry*; D012680:Sensitivity and Specificity; D013094:Spermatozoa / Q000166:cytology; D014621:Vagina / Q000737:chemistry*
chemical_list: D000135:Acid Phosphatase; D017430:Prostate-Specific Antigen
keywords: Acid phosphatase; PSA; Prostate specific antigen; Rape; Semen detection; Sperm