Alpha Fetoprotein AFP
Also known as
AFP, Total AFP, AFP-L3%
The test is ordered by the doctor when he or she wants to monitor therapy for cancers related to the ovaries, testicles, and liver. In addition, the test aids in the diagnosis of cancers related to these organs.
The test is ordered by the doctor when he or she suspects that the patient may have cancer of the ovaries, testicles, or liver. The doctor may order the test multiple times during treatment and after treatment. In some cases, the test may be ordered by the doctor when the patient has a condition that may make them more susceptible to liver cancer like cirrhosis or chronic hepatitis.
This is a blood test. The doctor draws a sample from a vein in your arm using a syringe and sends the sample to the lab for testing.
There is no special preparation needed for the test.
AFP refers to alpha-fetoprotein. AFP is a protein made by the liver in a fetus. When the baby is born, AFP levels increase and then decrease very quickly. These are normal conditions with AFP. However, outside of pregnancy and birth, AFP levels tend to be abnormal. Certain types of cancers and liver damage may increase AFP levels by large margins. The doctors use this test to assess the levels of AFP present in the body and draw conclusions based on the corresponding results. AFP is made by the liver when the liver cells are regenerating.
In conditions related to the liver like cirrhosis and hepatitis, AFP may be elevated in the body consistently. AFP exists in the body in several different forms. The standard test for AFP is known as total AFP, which measures all of the AFP forms in a holistic fashion. This is the test used in the U.S. Extremely high levels of AFP are linked to certain types of tumors, making the test a useful tumor marker. High levels of AFP are commonly found in people who have liver cancer called hepatocellular carcinoma. On the other hand, infants who have a rare type of liver cancer known as hepatoblastoma also have elevated levels of AFP in the body. In addition, people with testicular cancer as well as ovarian cancer may also have elevated levels of protein in the body.
The test used in the U.S. is the total AFP, which measures all the forms of AFP together. One commonly found form of AFP is known as L3. The AFP, L-3% test, is a test that has been newly introduced, which compares the amount of AFP-L3 to the total amount of AFP present. A higher percentage of L3 is linked to a higher risk of hepatocellular carcinoma. It is also linked to a poorer prognosis because cancers linked to L-3 tend to be ruthless and aggressive in comparison to other cancers. On the other hand, people who have hepatocellular carcinoma may have low total AFP but a higher AFP L-3. However, people with benign liver disease may have lower levels of AFP L-3 as well.
AFP and AFP L-3 are used alongside other tumor markers and ultrasound for hepatocellular carcinoma in certain places, like Japan – this is rarely the case in America. The test is commonly used to monitor people who have chronic liver diseases like cirrhosis, chronic hepatitis B, or hepatitis C, as they are at risk for developing liver cancer at any time in their life. However, many guidelines advise against the use of these tests for these purposes. The doctor may, however, order the tests alongside imaging studies to identify liver cancer when it is in its preliminary stage, and therefore much more treatable. The doctor may also use the test when the patient has hepatocellular carcinoma or some other AFP-related cancer to gauge the patient’s response.
The test is ordered by the doctor when:
- He or she suspects that the patient has liver cancer or certain cancers linked to the ovaries or testicles. Cancer may be suspected by the doctor if lumps are felt in the abdominal area during a physical exam or when imaging tests, detect possible tumors.
- The patient has been diagnosed with and treated for cancer-related to the liver, testicles, or ovaries.
- The doctor is monitoring the effectiveness of treatment in a patient with cancer related to the liver, testicle, or ovaries
- When the patient is being monitored for cancer recurrence
- He or she wants to follow up when the patient has chronic hepatitis or liver cirrhosis
Higher levels of AFP indicate the presence of cancer. This most commonly linked cancer is liver, ovarian, or a germ cell tumor of the testicle. However, it must be noted that not all conditions of these cancers will lead to an increase in AFP in the body. Higher levels of AFP may also be linked to cancers of the stomach, colon, lung, breast, and lymphoma. However, the test is almost never ordered to evaluate these conditions. Chronic conditions of the liver like cirrhosis and hepatitis may also lead to higher levels of AFP in the blood. When AFP levels are used to monitor how treatment for a certain type of cancer is progressing, decreasing levels are a good sign – they indicate a positive response to treatment by the body. If the levels of AFP do not decrease to normal levels, then the tumor tissue may still be present in the body.
On the other hand, if levels of AFP rise, then cancer has come back. However, it must be noted that levels of AFP tend to be higher in hepatitis or cirrhosis, which is why test results can be misleading. If the level of the protein was not elevated before treatment, the test would not be used by the doctor to monitor how effective the treatment was or to monitor for any chance of recurrence of cancer. If a person has chronic liver disease and AFP levels go from moderately high to extremely high, the risk of liver cancer increases. When total AFP and AFP L-3% are extremely high, then the risk of developing hepatocellular carcinoma is very high for the patient in the coming years.
Related Tests: Tumor Markers, Carcinoembryonic Antigen (CEA), CA-125, hCG Tumor Marker, Des-gamma-carboxy prothrombin (DCP)
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