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Alpha-Fetoprotein (AFP)

28 Azn
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Alpha-fetoprotein (AFP) is a glycoprotein structurally similar to albumin, primarily produced by the fetal liver, yolk sac, and gastrointestinal tract during embryonic development. It plays a crucial role in regulating oncotic pressure in fetal circulation and protecting the fetus from maternal immune responses.

In adults, AFP levels are typically elevated in chronic hepatitis, hepatocellular carcinoma, and malignant germ cell tumors.

Biomaterial: Venous blood
Pre-test recommendations:

  • The test can be taken at least 4 hours after the last meal.

Clinical Applications

In Obstetrics and Gynecology

  • Prenatal diagnosis of congenital fetal abnormalities, including:
    • Neural tube defects (e.g., spina bifida, anencephaly)
    • Omphalocele (umbilical hernia)
    • Esophageal atresia
    • Meckel syndrome (a genetic disorder with multiple congenital anomalies such as polydactyly, syndactyly, hypospadias, exstrophy of the bladder)
    • Fetal liver necrosis due to viral infections

In Oncology

  • Diagnosis and monitoring of primary hepatocellular carcinoma (HCC)
  • Detection of liver metastases
  • Screening high-risk individuals, such as:
    • Patients with liver cirrhosis
    • Hepatitis B virus (HBV) carriers
    • Alpha-1-antitrypsin deficiency

Causes of Elevated AFP Levels

  1. Prenatal Conditions

    • Open neural tube defects
    • Omphalocele
    • Esophageal atresia
    • Meckel syndrome
    • Fetal liver necrosis due to viral infections

  2. Oncological Conditions

    • Primary hepatocellular carcinoma (HCC)
    • Teratoblastoma of the ovaries and testes
    • Malignant tumors of other organs (pancreas, stomach, colon, lungs) – moderate AFP elevation

  3. Liver and Systemic Diseases

    • Chronic hepatitis
    • Liver cirrhosis
    • Alcoholic liver damage

Causes of Decreased AFP Levels

  • Fetal demise (pregnancy loss)
  • Abnormally low AFP levels
  • Trisomy 18 (Edwards syndrome)
  • Trisomy 21 (Down syndrome)(after 10 weeks of pregnancy)

AFP as a Prognostic Marker

  • A decrease in AFP levels after tumor removal and treatment is considered a positive prognostic sign.
  • Persistent or rising AFP levels post-treatment may indicate tumor recurrence or incomplete therapy response.