Elevated Alpha-Fetoprotein? Here's What You Should Know

Alpha-fetoprotein (AFP) is an acidic glycoprotein produced by the liver and yolk sac during early fetal development. It typically disappears shortly after birth. Today, measuring AFP levels in blood serum is a key clinical tool for diagnosing liver cancer and serves as a tumor marker for primary hepatocellular carcinoma.

Understanding the Clinical Relevance of Elevated AFP

While elevated AFP levels can be an important early indicator, its diagnostic significance is limited. Patients who receive test results showing high AFP levels should not panic, as not every increase points to liver cancer. There are several possible explanations for elevated AFP, and a comprehensive approach is necessary for accurate diagnosis.

1. Assess for Pregnancy and Liver Disease History

The first step is to determine whether the individual is pregnant or has a history of liver disease. In pregnant women, AFP levels are naturally higher, and elevated levels can indicate fetal abnormalities. This requires further diagnostic testing and medical evaluation.

2. Monitor Pregnancy Closely

In prenatal care, if AFP levels exceed 400 μg/L, it may indicate developmental issues in the fetus. In such cases, additional diagnostic tests are recommended to confirm the condition. If serious abnormalities are detected, termination of pregnancy may be advised under medical supervision.

3. Consider False Positives

It's important to note that AFP tests can sometimes yield false-positive results. To improve diagnostic accuracy, AFP testing is often combined with other markers such as carcinoembryonic antigen (CEA). This dual approach increases both the sensitivity and specificity of the test.

4. Liver Conditions Can Cause Temporary Increases

Patients with chronic liver conditions like hepatitis or cirrhosis may experience transient increases in AFP levels. These levels are usually below 400 μg/L and last no more than two months. Proper differential diagnosis is crucial. Regular follow-ups and repeat testing are recommended. Additionally, managing underlying liver disease with appropriate treatment, avoiding hepatotoxic drugs, and maintaining a healthy diet can help stabilize AFP levels.

5. Investigate for Liver Tumors

When AFP levels are only slightly elevated, imaging techniques such as liver ultrasound or CT scans can help distinguish between benign liver conditions and malignancies. It's worth noting that approximately 10% of healthy individuals may have mildly elevated AFP levels without any underlying disease.

Next Steps After Detecting High AFP Levels

If your test results show elevated alpha-fetoprotein, it's essential not to overreact. Instead, consult with a healthcare professional for further evaluation. Additional tests and monitoring can help rule out serious conditions. Once non-cancerous causes are confirmed, regular follow-up testing and observation are still important to ensure long-term health and early detection of any changes.