AFP

DESCRIPTION: AFP by its structure is a glycoprotein and belongs to the group of oncofetal proteins. It is created during embryonic development in the liver and yolk sac of the fetus. AFP passes through the placenta and is therefore normally found in pregnant women. In the diagnosis of malignant tumors, AFP is important for detecting and monitoring the course of the disease in primary liver cancer, as well as testicular and ovarian cancer. It can also be useful for screening. In hepatoma, the concentration of AFP is increased by more than 90%, so it can be used as a “screening” test in risk groups (groups), for example, in patients with chronic hepatitis or cirrhosis. High values of AFP concentration indicate a large tumor mass and a poor prognosis of the disease. The doctor will request the determination of AFP in the blood if: he suspects the existence of cancer of the liver, testicles or ovaries, he knows that the patient has already been examined or treated for these diseases, if the patient suffers from chronic hepatitis or cirrhosis. DETERMINATION: Method of determination: CMIA Sample: serum or plasma (heparin or EDTA). The stability of the sample is 7 days at 2-8°C, more than 7 days at -20°C CLINICAL SIGNIFICANCE: Increased AFP levels are more common in areas where hepatocellular carcinoma is endemic (Africa) and in patients with positive hepatitis B antigen (positive HbsAg). Elevated AFP is one of the most reliable single markers of malignancy available today. As such, it could be used as a screening method in the population at risk for developing liver cancer. Elevated AFP values can mean that there is cancer of the liver, ovaries, testicular germ cells or other cancers (stomach, colon, lung, breast, lymphoma). A slight increase in AFP levels occurs in patients with chronic hepatitis or cirrhosis. In these patients, the increase in AFP concentration is much more important than the current numerical value obtained. In 5-10% of patients with hepatocellular carcinoma, as confirmed by histological results, the AFP concentration is in the reference range AFP concentration in patients receiving cytostatic therapy, AFP values can be normalized despite tumor progression. Elevated AFP levels are not necessarily associated with liver metastases. AFP is rarely elevated in healthy individuals, and increases in only a few non-malignant diseases: eg hereditary tyrosinosis, ataxia-telangiectasia and certain liver diseases such as acute viral or drug-induced hepatitis and conditions when the liver is being regenerated. In these diseases, increases in AFP levels are below 500 micro g/L and do not indicate hepatocellular carcinoma. Therefore, AFP is a useful marker for the diagnosis of hepatocellular carcinoma and germ cell tumors, since these are the only conditions where the concentration of AFP is above 500 micro g/L. In both of these tumor types, AFP is used for diagnosis and therapy monitoring. 1) Physiological changes in AFP concentration in serum (plasma) 2) Pathological changes in AFP concentration in serum (plasma) A) Increased values of AFP concentration in serum (plasma) in: Acute and subacute necrosis of the liver / Alcoholic cirrhosis / Abscesses of the liver (pyogenic) / Biliary cirrhosis of the liver, unspecified / Diseases of the biliary system, unspecified / Cerebral ataxia with damaged DNA repair; Ataxia-Telangiectasia (Louis-Bar syndrome) / Cytomegalic inclusion disease / Down’s syndrome / Hepatorenal syndrome / Bladder cancer, bladder malignancy / Testicular cancer, testicular (testicle) malignancy / Chronic active hepatitis / Chronic hepatitis / Chronic viral hepatitis C / Testicular malignancy, unspecified / Nephrotic syndrome / Neonatal jaundice, unspecified / Secondary malignant neoplasm of the liver; cancer metastases in the liver / Testicular Nonseminoma tumor / Viral hepatitis / Liver failure; hepatic coma / Malignant neoplasm of the cervix (cervix) / Malignant neoplasm of the colon (colon), colon cancer (colon) / Malignant neoplasm of the liver, liver cancer, liver cell cancer / Malignant neoplasm of the liver, (metastases) unspecified / Malignant neoplasm of the ovary (Ovarian cancer) / Malignant neoplasm of the stomach, gastric cancer, gastric cancer / Malignant neoplasm of the gallbladder / Jaundice with liver cell damage (newborns) B) Decreased values of AFP concentration in serum (plasma) in: Alcoholism / Condition after kidney transplantation RISK FACTORS: Decreased values: Alcoholism Exposure of samples to a temperature of 56°C Lipemia (triglycerides > 11 mmol/L) Theophylline (blood collection within 2 hours of the last intake drug) Kidney transplantation Elevated values: Hemodialysis Exposure of samples to a temperature of 56°C Prematurity Pregnancy In the primary sample stored at +4°C the value for AFP is higher by 30% compared to serum stored at -20°C EFFECT OF DRUGS: Reduced values: Analytical reduced values: Dipiron Acetaminophen Aspirin Phenacetin RESULT: The reference range depends on gender, age and work method. The reference interval is displayed on each validated result.