Pathology Handbook

Alpha-fetoprotein (tumour marker)

Synonyms

AFP

Clinical Indications

AFP tumour production mainly confined to 3 malignancies: Non-seminomatous germ cell tumours (NSGCT) of testis, ovary and other sites, hepatocellular carcinoma and hepatoblastoma (in children, extremely rare in adults). In addition, AFP may be occasionally elevated in patients with various adenocarcinomas.

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Availability

On request

Specific Criteria

In cirrhosis or chronic hepatitis to rule out hepatocellular carcinoma. Known or clinically suspected hepatocellular or testicular carcinoma. AFP should not be used to screen for liver metastasis.

Turnaround Time

4 days

Specimen

Serum in gold-top vacutainer

Volume

1 ml

Container

Vacutainer gold top

Causes for Rejection

Unlabelled or incorrectly labelled sample; not meeting specific criteria for analysis; delay in sample reaching laboratory or in wrong sample container

Reference Range

< 7.5 U/mL

Half-life in Serum

Approx. 5 days.

Interpretation

AFP elevated in 70-90% of patients with hepatocellular cancers with levels between 1,000 and 100,000, and 40-60% of patients with germ cell tumours of the testis. Benign conditions associated with elevated AFP include hepatitis, cirrhosis, biliary tract obstruction, alcoholic liver disease and ataxia telangiectasia.
The rate of change of AFP level is important, an increasing rate suggests malignancy in the liver.