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Test ID: AFP Alpha-Fetoprotein (AFP) Tumor Marker, Serum

Reporting Name

Alpha-Fetoprotein, Tumor Marker, S

Useful For

Follow-up management of patients undergoing cancer therapy, especially for testicular and ovarian tumors and for hepatocellular carcinoma

 

Often used in conjunction with human chorionic gonadotropin.(2)

 

This test is not recommended as a screening procedure for cancer detection in the general population.

 

This test is not intended for the detection of neural tube defects.

 

This test is not useful for patients with pure seminoma or dysgerminoma.

Clinical Information

Alpha-fetoprotein (AFP) is a glycoprotein that is produced in early fetal life by the liver and by a variety of tumors including hepatocellular carcinoma, hepatoblastoma, and nonseminomatous germ cell tumors of the ovary and testis (eg, yolk sac and embryonal carcinoma). Most studies report elevated AFP concentrations in approximately 70% of patients with hepatocellular carcinoma. Elevated AFP concentrations are found in 50% to 70% of patients with nonseminomatous testicular tumors.(1)

 

AFP is elevated during pregnancy. Persistence of AFP in the mother following birth is a rare hereditary condition.(2) Neonates have markedly elevated AFP levels (>100,000 ng/mL) that rapidly fall to below 100 ng/mL by 150 days and gradually return to normal over their first year.(2)

 

Concentrations of AFP above the reference range also have been found in the serum of patients with benign liver disease (eg, viral hepatitis, cirrhosis), gastrointestinal tract tumors, and along with carcinoembryonic antigen, in ataxia telangiectasia.

 

The biological half-life of AFP is approximately 5 days.

Interpretation

Alpha-fetoprotein (AFP) levels may be elevated in association with a variety of malignancies or benign diseases.

 

Failure of the AFP value to return to normal by approximately 1 month after surgery suggests the presence of residual tumor.

 

Elevation of AFP after remission suggests tumor recurrence; however, tumors originally producing AFP may recur without an increase in AFP.

Analytic Time

1 day

Day(s) and Time(s) Performed

Monday through Friday; 5 a.m.-12 a.m.

Saturday; 6 a.m.-6 p.m.

Clinical Reference

1. Sturgeon CM, Duffy MJ, Stenman UH, et al: National Academy of Clinical Biochemistry laboratory medicine practice guidelines for use of tumor markers in testicular, prostate, colorectal, breast, and ovarian cancers. Clin Chem 2008 Dec; 54(12):e11-79

2. Blohm ME, Vesterling-Horner D, Calaminus G, et al: Alpha-1-fetoprotein (AFP) reference values in infants up to 2 years of age. Pediatr Hematol Onco 1998 Mar-April;15(2):135-142

3. Milose JC, Filson CP, Weizer AZ, et al: Role of biochemical markers in testicular cancer: diagnosis, staging, and surveillance. Open Access J Urol 2011 Dec 30;4:1-8

4. Schefer H, Mattmann S, Joss RA: Hereditary persistence of alpha-fetoprotein. Case report and review of the literature. Ann Oncol 1998 June;9(6):667-672

Method Name

Immunoenzymatic Assay

Specimen Type

Serum


Advisory Information


This test is used as a tumor marker and is not intended for the detection of neural tube defects. For testing amniotic fluid specimens, order AFPA / Alpha-Fetoprotein, Amniotic Fluid.



Specimen Required


Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 0.6 mL


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 7 days
  Frozen  90 days

Special Instructions

Reference Values

<8.4 ng/mL

Reference values are for nonpregnant subjects only; fetal production of AFP elevates values in pregnant women.

 

Range for newborns is not available, but concentrations over 100,000 ng/mL have been reported in normal newborns, and the values rapidly decline in the first 6 months of life.(See literature reference: Ped Res 1981;15:50-52) For further interpretive information, see Alpha-Fetoprotein (AFP) in Special Instructions.

 

Serum markers are not specific for malignancy, and values may vary by method.

Test Classification

This test has been cleared, approved or is exempt by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

82105

LOINC Code Information

Test ID Test Order Name Order LOINC Value
AFP Alpha-Fetoprotein, Tumor Marker, S 53962-7

 

Result ID Test Result Name Result LOINC Value
AFP Alpha-Fetoprotein, Tumor Marker, S 53962-7

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-General Request (T239)

-Oncology Test Request (T729)

Mayo Clinic Laboratories | Neurology Catalog Additional Information:

mml-Neuroimmunology, mml-Neuro-oncology, mml-Pediatric