Pathology Associates Of Lexington, P.A.
Pathology Associates Of Lexington, P.A.
Pathology Associates Of Lexington, P.A.
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        AFP Test
Alpha-fetoprotein, serum
This is a 70-kDa glyco-protein synthesized in liver, yolk sac, certain  germ-cell tumors, and the GI tract of the developing fetus. It is a component of the "triple test" often performed  early in a pregnancy in order to ascertain the risk of certain birth defects. It is a marker useful in helping to determine the nature of some liver tumors; and it can be used for post-treatment follow-up of germ-cell tumors (particularly of the testicle) which had an elevated AFP level at the time of initial diagnosis. prenatal OB monitoring

Conditions causing ELEVATIONS of this marker:

  • pregnancy: about 75% of neural-tube defects (such as spina bifida), about 60% of Down's syndrome, and about 80% of trisomy 18...[there can be "false positives"]
  • mediastinal, testicular, and other locations of germ cell malignancies having an adenocarcinomatous component
  • hepatocellular carcinoma (hepatoma) of the liver
  • Mild elevations not uncommon in cholangiocarcinoma. Rare cholangiocarcinomas can give a highly elevated serum AFP and have negative hepatocyte IHC markers1.
  • cirrhosis and other liver diseases undergoing some regenerative activity
  • congenital tyrosinemia

Situations wherein the level is not elevated:

  • some of the above birth defects don't elevate
  • many germ cell tumors don't elevate
  • not all hepatomas elevate AFP




  1. HERE Vij K & Wang HL, "Aberrant Expression of -Fetoprotein in Intrahepatic Cholangiocarcinoma: An Exceptional Occurrence", International Journal of Surgical Pathology, Vol. 16, No. 2, 194-198 (2008)

(posted 9 March 2008; latest addition 6 February 2009)

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