Alpha-fetoprotein

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Alpha-fetoprotein
Alpha-fetoprotein (AFP)
Raised serum alpha-fetoprotein
Raised alpha-fetoprotein
Altered alpha-fetoprotein
Alpha fetoprotein reduction
Reduced serum AFP
Serum AFP reduction
Conditions associated with altered alpha fetoprotein levels
serum AFP elevation
Raised AFP
Raised serum alpha fetoprotein levels
Alpha fetoprotein (AFP) elevation

Alpha-fetoprotein (AFP) is an important plasma protein synthesized by the yolk sac and fetal liver. In adults, its main utility is as a tumor marker, primarily for hepatocellular carcinoma or teratoma. Functionally it is the fetal homologue of albumin i.e. it acts as a major carrier protein in the antenatal circulation. It is encoded by the AFP gene .

Alpha-fetoprotein (AFP) elevation 

This may occur in a broad spectrum of conditions:

• liver tumors (hepatocellular carcinoma, hepatoblastoma)
  • <10 ng/mL is within normal limits
  • >20 ng/mL is above normal limits but has low specificity for tumor since it may occur in a setting of diffuse liver injury
  • increasing AFP over time, especially with stable AST and ALT is suspicious
  • AFP has a low sensitivity and specificity for hepatic malignancy
  • in the presence of an HCC, an elevated AFP level is indicative of an aggressive tumor
• pancreatic tumors 
  • pancreatoblastoma
• antenatal conditions (maternal serum AFP (MSAFP))
  • normal pregnancy
    • rises from 12 weeks and peaks during the early 3trimester
    • increased in multifetal pregnancy
  • neural tube defects
  • omphalocele
  • OEIS complex
  • cloacal exstrophy
  • gastroschisis
  • limb-body wall complex
  • placental chorioangioma
  • placental lakes
• germ cell tumors
  • sacrococcygeal teratoma
  • intracranial embryonal carcinoma
  • ovarian embryonal carcinoma 
  • immature teratoma
    • immature ovarian teratoma 
  • epignathus
  • yolk sac tumors
    • testicular yolk sac tumor
    • ovarian yolk sac tumor 
    • intracranial yolk sac tumor
  • ovarian Sertoli-Leydig cell tumor (rarely)
• other tumors

  • fetal adenocarcinoma of the lung

• non-malignant conditions
  • biliary atresia
  • chronic active hepatitis
  • cirrhosis
  • hereditary tyrosinemia type I
  • hereditary persistence of AFP

Alpha-fetoprotein (AFP) reduction

This may be seen in pregnancy.

AFP reduction may be associated with:

• certain chromosomal anomalies
  • Down syndrome
  • Turner syndrome
  • trisomy 13
  • trisomy 18
• Cornelia de-Lange syndrome 

See also

• tumor markers

Siehe auch:

• CA 125 elevation
• CA 19-9 elevation