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Alpha-fetoprotein (AFP): what the test shows and who it is prescribed for
What is alpha-fetoprotein (AFP)?
Alpha-fetoprotein (AFP) is a protein that is synthesized in the liver and gastrointestinal tract of the embryo. It is normally present in the blood of the fetus and mother during pregnancy. In adults, elevated levels of AFP can be marker of liver, ovarian, testicular tumors and some other conditions.
In accordance with FDA, AFP analysis is an important component of diagnosis in cases of suspected hepatocellular carcinoma (liver cancer), as well as part of the triple test during pregnancy.
When is an AFP test prescribed?
during pregnancy to assess the condition of the fetus (at 15–20 weeks)
if primary liver cancer is suspected
for monitoring patients with cirrhosis or chronic hepatitis B/C
in the diagnosis of ovarian and testicular tumors
to control relapse after cancer treatment
AFP blood levels
| Category | AFP level (ng/ml) |
|---|---|
| Adults (non-pregnant) | < 10 |
| Pregnant women (15–20 weeks) | 15–95 (depending on the week) |
| Over 500 (in adults) | Probable liver tumor |
Elevated AFP in non-pregnant patients is most often associated with hepatocellular carcinoma, but it can also be the case germ cell tumors, liver metastases, active hepatitis.
What can affect the result?
pregnancy
liver disease (hepatitis, cirrhosis)
alcoholic or toxic intoxication
recent surgeries
taking medications that affect liver function
How to prepare for the analysis
to take the test on an empty stomach
avoid alcohol for 24 hours
inform the doctor about all medications taken
do not perform an ultrasound examination of the liver the day before
Interpretation of AFP results
| AFP level | Possible values | Next steps |
|---|---|---|
| <10 ng/ml | Norm for non-pregnant women | Observation |
| 10–500 ng/ml | Chronic liver disease | Monitoring, ultrasound |
| >500 ng/ml | Suspected hepatocellular carcinoma | Additional examination (CT, MRI, biopsy) |
In pregnant women, changes in AFP levels may indicate: congenital malformations of the fetus (e.g. neural tube defects), so the test is often performed along with hCG and estriol as part of prenatal screening.
Application in oncology
AFP is widely used for:
detection hepatocellular carcinoma in the early stages
evaluation of the effectiveness of tumor treatment
control after surgery
diagnostics germ cell tumors in men
As noted Mayo Clinic, AFP levels can be an early signal of cancer, even before clinical symptoms appear.
The AFP test is a universal marker: in pregnant women, to assess fetal health, in adults, for early detection of dangerous tumors. Its regular use in risk groups can significantly increase the chances of early diagnosis.
