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Overview of AFP

AFP (alpha-fetoprotein) is a protein produced by the liver and yolk sac of a fetus during development. After birth, AFP levels in the blood drop rapidly and remain very low (less than 10 ng/mL) in healthy adults.

In medicine, AFP is considered an important tumor marker, primarily used to support the diagnosis and monitoring of hepatocellular carcinoma (HCC), the most common type of primary liver cancer. Additionally, AFP levels may rise in other liver-related diseases and certain types of germ cell tumors.

Clinical role of AFP

• Primary liver cancer detection: Abnormally high AFP levels are frequently found in patients with hepatocellular carcinoma.

• Treatment monitoring: After tumor resection or intervention, AFP levels typically decrease significantly. If levels remain high or rise again, it may suggest residual tumor or recurrence.

• Prognostic assessment: Higher AFP levels often correlate with advanced tumor stages and a greater risk of metastasis.

• Surveillance for high-risk patients: For individuals with cirrhosis or chronic viral hepatitis, AFP helps in early detection when combined with regular liver ultrasounds.

Normal and abnormal values

• Normal range: AFP < 10 ng/mL.

• AFP 10 – 400 ng/mL: Can be seen in chronic hepatitis, cirrhosis, germ cell tumors, or early-stage liver cancer.

• AFP > 400 ng/mL: Strongly suggests hepatocellular carcinoma, especially in patients with underlying liver disease (hepatitis B, C, or cirrhosis).

⚠️ Note: Not all liver cancer patients show elevated AFP. Approximately 30–40% of cases (especially in early stages) have AFP levels within the normal range.

Sensitivity and specificity

• Sensitivity: Approximately 60–70% for liver cancer diagnosis.

• Specificity: Approximately 80–90%, particularly when AFP levels exceed 400 ng/mL.

• Combined screening: Using AFP alongside regular liver ultrasounds increases the chance of early cancer detection in high-risk groups.

Causes of elevated AFP other than liver cancer

• Acute or chronic viral hepatitis (B or C).

• Cirrhosis.

• Germ cell tumors of the testes or ovaries.

• Other tumors: stomach, pancreas, or lung (rare).

• Pregnancy: physiological increase as the fetus produces AFP.

Indications for AFP testing

A physician may order an AFP test for:

• Patients with chronic liver disease (cirrhosis, hepatitis B, hepatitis C) for regular cancer screening.

• Individuals with abnormal liver ultrasound findings or suspected tumors.

• Monitoring patients diagnosed with liver cancer during and after treatment.

• Monitoring specific types of germ cell tumors.

Procedure and preparation

• Preparation: No fasting is required.

• Procedure: A standard venous blood draw.

• Results: Typically available within 1–2 business days.

• Interpretation: Doctors will evaluate AFP levels in conjunction with medical history and imaging such as ultrasound, CT scan, or MRI for an accurate diagnosis.

Limitations

• Does not detect all cases: 30–40% of early-stage liver cancer patients have normal AFP levels.

• Elevation in benign conditions: Hepatitis, cirrhosis, and pregnancy can cause high results.

• Not a substitute for biopsy: AFP is a supporting tool and is not sufficient for a definitive diagnosis on its own.

When to see a doctor

Consult a gastroenterologist or hepatologist if you have:

• A history of chronic hepatitis B, C, or cirrhosis.

• Dull pain in the upper right abdomen, jaundice, or unexplained weight loss.

• Abnormally high AFP results.

• An abnormal mass found on a liver ultrasound.

Frequently asked questions (FAQ)

1. Can an AFP test replace a liver ultrasound for screening? No. AFP is a supporting tool. Regular liver ultrasounds remain the primary method for early tumor detection.

2. Does high AFP guarantee liver cancer? No. AFP can rise due to several other conditions. Diagnosis requires a combination of ultrasound, CT, MRI, and potentially a biopsy.

3. Do patients with hepatitis B or C need regular AFP tests? Yes. Patients with chronic hepatitis or cirrhosis should have an AFP test and liver ultrasound every 6 months for cancer screening.

4. What does AFP mean after liver cancer treatment? AFP levels usually drop sharply after surgery. If they rise again, it may indicate cancer recurrence or metastasis.

5. How can I reduce liver cancer risk besides monitoring AFP? Get vaccinated against hepatitis B, treat chronic hepatitis B/C, limit alcohol consumption, maintain a healthy weight, and have regular medical check-ups.

Conclusion

The AFP test is a vital marker for detecting and monitoring hepatocellular carcinoma. However, it is not sufficient for a definitive diagnosis and must be combined with imaging (ultrasound, CT, MRI) and clinical evaluation.

For high-risk groups (cirrhosis, chronic hepatitis B/C), screening with AFP and liver ultrasound every 6 months is the best way to detect liver cancer early and improve treatment outcomes.

To schedule an AFP liver cancer marker test at DYM Medical Center Vietnam, please contact us:

• DYM Medical Center Saigon: Room B101-B103, Basement 1, mPlaza Saigon Building, No. 39 Le Duan, Sai Gon Ward, Ho Chi Minh City

• DYM Medical Center Phu My Hung: Room 3A01, 3A Floor, The Grace Building, 71 Hoang Van Thai Street, Tan My Ward, Ho Chi Minh City

• DYM Medical Center Hanoi: B1 Basement, Epic Tower, Alley 19 Duy Tan, Cau Giay Ward, Ha Noi

• Hotline: 1900 29 29 37