α-Fetoprotein

Clinical use
Diagnosis and management of primary liver cancer, gonadal tumours, rare carcinomas (particularly of the gastrointestinal tract) and in certain non-neoplastic hepatic diseases.

If a gonadal tumour is suspected, measurement of hCG should be requested also.

Patient Preparation
None. Take blood (5 mL) into a plain tube.

To facilitate assessment of therapy, it is important that a sample be obtained before treatment is initiated.

Sample Preparation
Send serum (0.5 mL) to the SAS laboratory. Record on the SAS request form whether the patient is hepatitis antigen or antibody positive, clinical diagnosis, information on radio- or chemotherapy and, if appropriate, the result of CT or ultrasound liver scan.

Reference Range
Adults: <14 kU/L

In primary liver cancer, 80% of patients with hepatocellular cancer have serum a-fetoprotein >300 kU/L. Some chemotherapeutic agents, e.g. cis-platinum, cause elevation of a-fetoprotein values, which usually reach a consistent plateau, then may take many months to decline to normal after completion of therapy.

Centre offering this assay
London Imperial Charing Cross Hospital Oncology Laboratory.

References
Coppack S, Newlands ES, Dent J, Mitchell H, Goka G, Bagshawe KD. Problems of interpretation of serum concentrations of alpha-foetoprotein (AFP) in patients receiving cytotoxic chemotherapy for malignant germ cell tumours. Br J Cancer 1983; 48, 335-340.

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