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.