From the Guidelines
A high alpha-fetoprotein (AFP) level typically indicates potential liver disease, certain cancers, or pregnancy-related conditions, and warrants further investigation with imaging studies, biopsies, or other blood tests to determine the underlying cause. In adults, elevated AFP may suggest hepatocellular carcinoma (liver cancer), chronic liver diseases like cirrhosis or hepatitis, or testicular or ovarian germ cell tumors 1. During pregnancy, high AFP levels might indicate neural tube defects in the developing fetus, multiple pregnancies, or certain chromosomal abnormalities like Down syndrome. The normal range for non-pregnant adults is generally below 10 ng/mL, with levels above this threshold warranting further investigation.
- Key points to consider:
- Elevated AFP levels are not specific to a particular condition and can be associated with various liver diseases and cancers.
- The degree of elevation can provide clues about the potential condition, with modest elevations suggesting chronic liver disease and very high levels more commonly associated with cancer or pregnancy complications.
- AFP is not a definitive diagnostic tool on its own and should be used in conjunction with other diagnostic tests, such as imaging studies and biopsies, to determine the underlying cause of elevated levels 1.
- The use of AFP as a screening test for hepatocellular carcinoma (HCC) is limited due to its low sensitivity and specificity, and it is no longer recommended as a screening test by some guidelines 1.
- The most recent and highest quality study, published in 2021, suggests that an elevated AFP level in conjunction with imaging results showing a growing liver mass has a high positive predictive value for HCC, but the diagnostic accuracy of an absolute AFP cutoff value has not been validated in this setting 1.
From the Research
Alpha-Peta Protein Levels
A high alpha-peta protein level, also known as alpha-fetoprotein (AFP), can be an indicator of various health conditions. The following points summarize the implications of high AFP levels:
- High AFP levels are often associated with hepatocellular carcinoma (HCC), a type of liver cancer 2, 3, 4.
- Elevated AFP levels can also be found in patients with benign liver diseases, such as acute hepatitis and chronic liver disease 2, 5.
- In adults, high AFP levels are more likely to be associated with malignancies, particularly HCC, while in children and infants, elevated AFP levels are often found without malignancy 3.
- A persistently increased AFP level is a risk factor for HCC progression and may be involved in the development of multidrug resistance in patients with liver cancer 4.
- Serum AFP levels can increase more than 10 years before the detection of HCC, making it a potential marker for early detection and surveillance 6.
- The accuracy of AFP as a tumor marker can be improved by combining it with other biomarkers, such as AFP-L3, GP73, and des-gamma-carboxyprothrombin 5.