02/18/2026
The acid phosphatase test measures the activity of acid phosphatase, a lysosomal enzyme that hydrolyzes phosphate esters in an acidic environment (optimal pH ~4.5–5.0). It is present in several tissues, particularly the prostate, liver, spleen, bone marrow, and red blood cells. Historically, prostatic acid phosphatase (PAP) was used as a tumor marker for prostate cancer, especially in metastatic disease, but it has largely been replaced by prostate-specific antigen (PSA) due to superior sensitivity and specificity. The test may still be used in selected contexts, including evaluation of suspected prostate carcinoma, forensic identification of semen, and diagnosis of certain lysosomal storage disorders. Elevated levels can also occur in hemolysis, thrombocytosis, and bone disease. Specimens should be processed promptly or frozen, as ACP is unstable at room temperature.