Clinical Information

It has been shown that elevation of serum AFP above values typically found in healthy individuals occurs in several malignant diseases, most notably nonseminomatous testicular cancer and primary hepatocellular carcinoma. In the case of nonseminomatous testicular cancer, a direct relationship has been observed between the incidence of elevated AFP levels and the stage of disease. Elevated AFP levels have also been observed in patients diagnosed as having seminoma with nonseminomatous elements but have not been observed in patients with pure seminoma. Human chorionic gonadotropin (hCG) and AFP are also important prognostic indicators of survival rate among patients with advanced nonseminomatous germ cell testicular tumors.

For patients in clinical remission following treatment of nonseminomatous testicular cancers, AFP levels generally decrease. Post-operative AFP values which fail to return to normal strongly suggest the presence of residual tumor. Tumor recurrence is often accompanied by a rise in AFP before progressive disease is clinically evident. Greater than 70% of patients with primary hepatocellular carcinoma have been reported to have elevated levels of serum AFP. Elevated AFP levels have occasionally been found in association with gastrointestinal tract cancers with and without liver metastases and only rarely in other malignancies. Serum AFP has been found to be elevated during pregnancy, in diseases such as ataxia telangiectasia, hereditary tyrosinemia, teratocarcinoma and in benign hepatic conditions such as acute viral hepatitis, chronic active hepatitis and cirrhosis. Elevation of serum AFP in benign hepatic diseases is usually transient.

AFP testing is not recommended as a screening procedure to detect cancer in the general population.