ALPHA FETOPROTEIN - serum

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Specimen: 5 mL blood in plain tube.

Method: Immunoassay.

Reference Interval: Method dependent.

Adult, non-pregnant: <10 µg/L

Normal pregnancy: varies with gestational age; results may be expressed as multiples of the median, see DOWN SYNDROME ANTENATAL RISK TESTING .

Application: Detection and monitoring of hepatocellular carcinoma and germ cell tumours , particularly for recurrence after treatment. Assessment of risk for neural tube and other defects in utero, including Down syndrome (one of the components of the “triple test”).

Interpretation: Hepatocellular carcinoma is usually associated with very high levels of a-fetoprotein, but a normal level does not exclude the diagnosis of this, or of germ cell tumour. Moderate increases may occur with non-malignant disease associated with liver cell regeneration. Increased levels have high sensitivity and low specificity for fetal abnormalities. Low maternal levels are associated with Down syndrome pregnancies; results must be interpreted in conjunction with other tests. Consult pathologist. See also DOWN SYNDROME ANTENATAL RISK TESTING

Reference: Brock DJH. Biochem Soc Trans 1979; 7: 1179-1195. Posner MR and Mayer RJ. Haematol Oncol Clin N Amer 1994; 8: 533-554.

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