Most studies report elevated afp concentrations in approximately 70% of patients. High levels of afp may suggest the developing baby has a neural tube defect such as spina bifida or anencephaly. Some tumor markers are specific for a particular type of cancer, while others are seen in several cancer types. What is the role of serum alphafetoprotein afp in the. Tumor markers are blood tests used to find different kinds of cancers. Alphafetoprotein tumor marker blood does this test have other names. Alphafetoprotein alfafetoproteen can be found with a blood test and is also called afp. An afp tumor marker test is a blood test that measures the levels of afp in adults.
However, this use of afp level does not qualify it as a screening test. National coverage determinations coding policy manual and change report icd10cm january 2017 effective january 1, 2017 m ed ic arlmited cov g t sts. Afp greatly decreases by age 1 and should only be found. Background and aims the role of alphafetoprotein afp in the diagnosis and surveillance of hepatocellular carcinoma hcc is getting smaller owing to the advances in imaging modalities. An ideal tumor marker should be highly sensitive, specific, reliable with high prognostic value, organ specificity and it should correlate with tumor stages. Consequently, tumor markers alone are not diagnostic for cancer. This is a blood test to look for alphafetoprotein afp in your blood. The afp tumor marker test can be performed on a blood sample, urine sample, or sample of amniotic fluid other names for the test include total afp, msafp maternal serum afp, and alpha.
Alpha fetoprotein afp levels may be elevated in association with a variety of malignancies or benign diseases. It is effective as a biochemical marker for monitoring the response of certain malignancies to therapy. High levels of alpha fetoprotein afp production by a benign ovarian serous cystadenoma. Pregnancy hepatic disorders malignancies hepatocellular carcinomas, germ cell tumors especially with yolk sac tumor components, neoplasms of endodermal origin lung, gastric, colon especially if associated hepatoid foci, liver metastases, pediatric tumors such. Examples of commonly used circulating tumor markers include calcitonin measured in blood, which is used to assess treatment response, screen for recurrence, and estimate prognosis in medullary thyroid cancer. When serum tumor markers for malignancies is not covered reimbursement is not allowed for any of the tumor markers listed above for any cancer indication not otherwise listed and all other applications of serum tumor markers, including but not limited to. Feb 28, 2006 serum alpha fetoprotein afp is the most widely used tumor marker in detecting patients with hepatocellular carcinoma, and has been proven to have capability of prefiguring the prognosis. About our alpha fetoprotein test, tumor marker this blood test is used to determine alpha fetoprotein also known as afp or a fetoprotein levels.
It is a protein made in the liver of a developing baby. Preanalytical factors preanalytical step may influence tumor marker levels, too. Afp is normally made by a fetuss liver and yolk sac. Afp is a tumor marker for liver and testicular cancer. The elecsys afp assay is intended for the in vitro quantitative determination of. To order this test without the serial monitor service, see. Findings of a previous clinical study demonstrated that serum afp had a sensitivity of 4165% and specificity of 8094% when the cutoff value is 20 ngml. Hepatocellular carcinoma is the most common cause of primary liver neoplasms and is one of the main causes of death in patients with liver cirrhosis. Afp greatly decreases by age 1 and should only be found in adults in very low levels. Alpha fetoprotein tumor marker alpha fetoprotein afp is a 69,000 kd single chain polypeptide which is similar in size and structure to human serum albumin.
Serum tumor marker surveillance is a valuable tool in assessing patients for relapse of malignant germ cell tumors and liver tumors. Aug 16, 2014 hepatitis b virus hbv infection is a serious public health problem worldwide. Alpha fetoprotein alpha fetoprotein afp is the major protein of fetal serum but falls to an undetectable level after birth. Collect and label sample according to standard protocols. This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin also termed as vitamin b7 or b8, vitamin h, or coenzyme r. The results are combined with the mothers age and ethnicity in order to assess the probabilities of potential genetic disorders. Pdf alphafetoprotein afp is a major mammalian embryospecific and tumor associated protein that is also present. An afp tumor marker test checks the level of this protein. An elevated level of a tumor marker can indicate cancer.
A tumor marker is a biomarker found in blood, urine, or body tissues that can be elevated by the presence of one or more types of cancer. This is a blood test to look for alpha fetoprotein afp in your blood. Therefore, afp levels are also frequently elevated in chronic active hepatitis c levels of 200300 ng. Hcpcs codes alphanumeric, cpt ama code description. Alpha fetoprotein coverage indications, limitations, andor medical necessity alpha fetoprotein afp is a polysaccharide found in some carcinomas. Alphafetoprotein tumor marker blood ucla health library. Alphafetoprotein afp as tumor marker in a patient with urothelial cancer with exceptional response to antipd1 therapy and an escape. Tumor markers afp 7k52 491521r6 b7k520 read highlighted changes revised august, 2010 tumor markers afp customer service. In patients with cirrhosis, an elevated afp level is a marker for increased risk of hcc. Elevation of afp after remission suggests tumor recurrence. The afp gene is located on the q arm of chromosome 4 4q25. Although not present in pure seminoma, 1 elevated serum afp is closely associated with nonseminomatous testicular cancer. Reliability of assay results cannot be guaranteed if there. Serum alpha fetoprotein afp is the most widely used tumor marker in detecting patients with hepatocellular carcinoma, and has been proven.
Use of an alternative tumor marker, desgammacarboxy prothrombin dcp, has been suggested in. However, it has been indicated that afpl3 and dcp excel afp in differentiating hepatocellular carcinoma from nonmalignant hepatopathy and detecting small. Alphafetoprotein afp is a glycoprotein that is produced in early fetal life by the liver and by a variety of tumors including hepatocellular carcinoma, hepatoblastoma, and nonseminomatous germ cell tumors of the ovary and testis eg, yolk sac and embryonal carcinoma. Alphafetoprotein afp tumor marker lab tests online. The study included 619 patients who were diagnosed with chb from march 2005 to december 2011. This study aimed to investigate the relationship between serum alpha fetoprotein afp levels and pathological stages of liver biopsy in patients with chronic hepatitis b chb. Ca125 measured in blood, to monitor how well cancer treatments are working and if cancer has come back in ovarian cancer. Afp levels may be elevated because of production by the tumor or by regenerating hepatocytes. Net alpha fetoprotein tumor marker june 7, 2010 to help doctors give their patients the best possible care, the american society of clinical oncology asco asks its medical experts to develop evidencebased recommendations for testing blood levels of tumor markers for germ cell tumors. Afp is a marker for hepatocellular and germ cell nonseminoma carcinoma. A nonclassic presentation article pdf available in obstetrics and gynecology international 41. Alpha fetoprotein is also produced by certain cancers, such as liver or testicular cancer, and is sometimes measured as a tumor marker see below.
Tests performed on serum are further categorized by the reason for performing the test. Serum markers are not specific for malignancy and values may vary by method. In addition to the elevations seen during pregnancy, serum values can be high in patients with a variety of liver diseases. Alphafetoprotein afp is an example of a tumor marker that can be used to aid in diagnosis of cancer, especially hepatocellular carcinoma hcc. Alphafetoprotein afp is a polysaccharide found in some carcinomas. Tumor marker value primary tumor s malignancies benign conditions. Tumor markers in infancy and childhood rosanna ricafort.
Though the test is often ordered to monitor people with chronic liver diseases such as cirrhosis, chronic hepatitis b or hepatitis c because they have an increased lifetime risk of developing liver cancer, most current guidelines do not recommend this use. Alphafetoprotein afp tumor marker, serum afp clinical. Serum tumor markers for detection of hepatocellular carcinoma. High alpha fetoprotein serum levels have been found in 6070% of patients with hepatocellular carcinoma.
The progressive elevation of alpha fetoprotein for the. Alphafetoprotein afp tumor marker, serum rice memorial. However, afp levels remain high during the first few months of life. Alphafetoprotein afp is a glycoprotein that is produced in early fetal life by the liver and by a variety of tumors including hepatocellular carcinoma. Alpha fetoprotein afp is a polysaccharide found in some carcinomas. Alphafetoprotein afp levels may be elevated in association with a variety of malignancies or benign diseases. Alpha fetoprotein afp is an important tumor marker in childhood. There are wellestablished tumor markers that are routinely used. Afp is an important fetal feetal serum protein that disappears soon after birth. It can also appear as a tumor marker in other adults.
More information about cancer staging is available on the staging page. Afp levels are often elevated above values found in healthy individuals in cases of several malignant diseases, such as liver damage. The aims of this study were to assess the diagnostic accuracy of tumor markers in small hcc and to find the optimal cutoff value of each tumor marker for efficient. Alphafetoprotein afp as tumor marker in a patient with urothelial cancer with exceptional response to antipd1 therapy and an escape lesion.
Diagnostic accuracy of tumor markers for hepatocellular. Human chorionic gonadotropin hcg and alpha fetoprotein afp in sera and tumor cells of patients with testicular seminoma. Pdf serum alpha fetoprotein levels in healthy fullterm. Afp is the most widely used tumor biomarker currently available for the early detection of hcc. Alpha fetoprotein afp is an example of a tumor marker that can be used to aid in diagnosis of cancer, especially hepatocellular carcinoma hcc. Serum tumor marker surveillance is a valuable tool in assessing patients for relapse of malignant germ cell tumors and liver. Feb 03, 2020 alpha fetoprotein alfafetoproteen can be found with a blood test and is also called afp. As a tumor marker, afp is useful in detecting germ cell tumors of the ovary and testis, primary hepatocellular carcinoma in adults, and hepatoblastoma in children. Contact your local representative or find country specific contact information on. However, the level of afp can also be increased in some liver diseases, although when it reaches a certain threshold it is usually indicative of hepatocellular carcinoma.
Package insert instructions must be carefully followed. Alphafetoprotein tumor marker blood health encyclopedia. Performance characteristics were verified by mayo clinic in a manner consistent with clia requirements. Pdf high levels of alpha fetoprotein afp production by. The most important application of afp testing in cancer management is for testicular cancer. In human embryos, afp is first made in the yolk sac and later in the fetal liver. Alpha fetoprotein afp is used as a tumor marker to help detect and diagnose cancers of the liver, testicles, and ovaries. Afp alphafetoprotein alpha fetoprotein, tumor marker afp, serum alphafetoprotein afp.
Afp levels are usually high when a baby is born, but fall to very low levels by the age of 1. The afp test is measuring high and low levels of alphafetoprotein. Elevated alpha fetoprotein refers to a state where alpha fetoprotein levels are outside of the reference range. Definition most of the wellknown markers may also be elevated in noncancerous conditions. Failure of the afp value to return to normal by approximately 1 month after surgery suggests the presence of residual tumor.
Alphafetoprotein afp tumor marker, serum mayo clinic. Most studies report elevated afp concentrations in approximately 70% of patients with hepatocellular carcinoma. A higher afp level doesnt always mean you have a health problem. Use of tumor markers in liver, bladder, cervical, and gastric cancers. Characteristics of an ideal tumor marker specificity for a single type of cancer high sensitivity and specificity for cancerous growth correlation of marker level with tumor size homogeneous i. Therapy therapy may influence tumor marker levels, too. Serum tumor markers for detection of hepatocellular carcinoma ncbi. Food and drug administration and is used per manufacturers instructions. Afp tumor specific glycoforms may improve specificity of afp for hcc. Afp is elevated in normal pregnancy, benign liver disease hepatitis, cirrhosis, as well as in cancer. Afp is a major plasma protein produced by the yolk sac and the fetal liver during fetal development. In a series of 66 patients with advanced hcc, whose response to sorafenib was assessed by recist, mrecist, and serum afp levels at four in diameter and in 28 percent of those with tumors between 2 and 5 cm. Alphafetoprotein afp is the major protein of fetal serum but falls to an undetectable level after birth.
The afp tumor marker test can be performed on a blood sample, urine sample, or sample of amniotic fluid other names for the test include total afp, msafp maternal serum afp, and alphafetoproteinl3 percent % diagnostic tests for liver cancer. Understand the role of tumor markers for diagnosis and management of patients with cancer. Alphafetoprotein afp is used as a tumor marker to help detect and diagnose cancers of the liver, testicles, and ovaries. Tumor marker decline has been evaluated as a potential prognostic marker to guide further therapy in such patients. Use of an alternative tumor marker, desgammacarboxy prothrombin dcp, has been suggested in patients with advanced. Measuring the blood levels of afp in suspicious cases helps in. Pdf alphafetoprotein afp as tumor marker in a patient with. Tumor markers may be measured before treatment to help doctors plan the appropriate therapy. The alpha fetoprotein afp tumor marker test measures the amount of alpha fetoprotein in blood in both adults and children. For instance, therapy may alter metabolic pathway of enzyme tumor markers, or cause temporary release of tumor markers in response to chemotherapy lysis phenomenon. Alpha fetoprotein afp is a glycoprotein that is produced in early fetal life by the liver and by a variety of tumors including hepatocellular carcinoma, hepatoblastoma, and nonseminomatous germ cell tumors of the ovary and testis eg, yolk sac and embryonal carcinoma. It is effective as a biochemical marker for monitoring the response of.