AFP methyl fetal protein

Not gold standard, for reference only

AFP is a glycoprotein, normally, the protein is mainly from the embryonic liver cells, the fetus after birth about two weeks after the fetal protein is disappeared from the blood, so the normal human serum in the content of the AFP is less than 20 μg/liter.

In the past, it has been considered as a specific tumor marker for diagnosing primary hepatocellular carcinoma, which has the function of establishing diagnosis, early diagnosis and differential diagnosis. A large number of clinical findings, some cirrhosis patients will be long-term AFP reached thousands, but for many years there is no sign of liver cancer, and found about 20% of patients with advanced liver cancer, until died, AFP still not more than 10.

the diagnosis of primary hepatocellular carcinoma by AFPThe serum AFP in patients with primary liver cancer increased up to 250ug ~ 6mg/ml, (even to 9mg/ml), equivalent to dozens of times times even tens of thousands of times times normal. In the early years of two-way diffusion detection, AFP positive for the diagnosis of liver cancer is of great value (table 2), in the world of liver cancer in the high incidence of about 50% of patients with liver cancer can be detected, but in the white liver cancer patients whose positive detection rate is very low.  In the above data, 10-30-year-old liver cancer patients with AFP positive rate of 100%, 31-40-year-old and 40-year-old liver cancer patients were 66% and 22%. High Hazard edit causes of high fetal protein⑴ liver cancer is one of the most common causes of high fetal protein, the normal human serum in the content of AFP is less than 20μg/l, but when the liver cell carcinogenesis, but also restore the function of the production of this protein, according to the survey found that about 80% of liver cancer patients in the serum of the AFP will rise, usually with 400μg/ L as a standard, above this value should consider the possibility of liver cancer, generally in the 8 months before the onset of liver cancer symptoms of AFP has risen, so cirrhosis, chronic hepatitis patients, families with liver cancer patients should be based on their own situation to do regular check. Therefore, AFP has a certain significance in the early diagnosis of hepatocellular carcinoma. A reminder is: can not only by virtue of the high-fetal protein (4) of the indicators to diagnose or exclude a disease is unreliable, because the discovery of liver cancer does not necessarily need a high-fetoprotein, some liver cancer may be a normal fetal protein value, it should be combined with other serological examination and imaging examination of comprehensive analysis, can increase the diagnostic reliability. ⑵ pregnant women and newborns will also appear a temporary increase in AFP, because AFP is the normal plasma protein components of the fetus, is the primary protein in the early embryo, pregnant women in pregnancy will significantly increase the protein, generally in the 3 months after pregnancy, a significant increase in AFP, maternal blood in pregnant women in July-August The highest peak and relatively stable, but it is still below 400μg/l, about 3 weeks after the postpartum gradually return to normal level. ⑶ High May and non-malignant diseases: such as acute and chronic hepatitis, severe hepatitis recovery period, cirrhosis, congenital bile duct occlusion, malformation fetus, such as AFP can be elevated, but the increase in the amplitude of the smaller, and the duration of the shorter. The high ⑷ may be associated with germ cell tumors: According to data, about 50% of patients with germ cell tumors have a positive AFP; some other gastrointestinal tumors such as pancreatic cancer or lung cancer and liver cirrhosis may also have different levels of AFP high; In addition, if the AFP is greater than 25μg/ Male patients in L also have to consider the possibility of testicular cancer. ⑸ Viral hepatitis: a mild, moderate increase in the activity phase of chronic hepatitis, generally in the 50~300μg/l, with hepatocellular carcinoma different points for the increase in the range of low, generally not continuous increase, after treatment reduced to normal. ⑹ Newborn hepatitis: 30% neonatal hepatitis can be detected by the AFP, the incidence of disease severity and increase, mostly significantly increased. This can be identified with congenital biliary atresia, the latter most of which are normal. ⑺ Other causes: Liver injury, congestive liver enlargement, ataxia, capillary dilatation, congenital tyrosine disease, pregnant women (3-6 months), testicular or ovarian embryonic tumors (such as fine proto-cell tumors, malignant teratoma, ovarian cancer, etc.) also often increased AFP. the harm of high-rise of AFPFirst, in adults, about 80% of patients with liver cancer have a higher level of AFP in serum, and a positive rate of AFP in germ cell tumors is 50%. Therefore, the high level of AFP generally means the occurrence of liver cancer. In normal human serum, the content of AFP is generally less than 20 micrograms per liter, but when the liver cell carcinogenesis, but also restore the function of producing this protein, so the high level of AFP should consider the possibility of liver cancer. Second, pregnant women with high AFP may mean that the fetus is defective. AFP can be used in maternal amniotic fluid or mother plasma for prenatal monitoring of the fetus. such as in the neural tube defect, spina bifida, no brain, etc., the AFP can be opened by the neural tube into the amniotic fluid, resulting in the amniotic fluid is significantly higher than the AFP. Fetal death in utero, teratoma and other congenital defects may also have a high level of fetal protein in the amniotic fluid. A fetal protein can be entered into the maternal blood stream through the amniotic fluid, in 85% spina bifida and no brain of the mother, in the 16-18 weeks of pregnancy, the high plasma AFP is diagnostic value, but must be combined with clinical experience to avoid false positive errors. Third, the high AFP may also be liver damage, congestive liver enlargement, ataxia, capillary dilatation, congenital tyrosine disease, pregnant women (3-6 months), testicular or ovarian embryonic tumors (such as fine proto-cell tumors, malignant teratoma, ovarian cancer, etc.) caused. Therefore, the high-fetal protein is not a good phenomenon for many people, it must cause the attention of patients, combined with medical history, imaging examination and so on to understand the causes of high-fetal protein, timely treatment, reduce the harm caused by AFP [5]. is a higher fetal protein a liver cancer?AFP is indeed an important indicator of the diagnosis of liver cancer, but not as long as the occurrence of AFP positive, can be diagnosed as liver cancer. The diagnosis of liver cancer must be dynamic observation of the changes in the content of AFP, if 1 consecutive months, the detection of AFP content has been greater than 400μg/l, it should be highly suspected of liver cancer, combined with imaging examination (b-ultrasound, CT and magnetic resonance imaging, etc.) can be diagnosed. If a fetoprotein is elevated or slightly elevated, it is not necessarily the liver cancer. Studies have reported that almost all hepatitis patients have elevated serum AFP, the majority of patients in the liver function back to normal, the AFP reached a peak. The findings suggest that the production of AFP is caused by the liver cells to repair the newborn, acute hepatitis patients such as transaminase began to decline, liver cells into the repair period, the highest concentration of AFP, after reaching the peak after the gradual decline or even disappear. In general hepatitis, the increase of AFP is not long, but after the transaminase return to normal, not only do not decline and obviously increase, should pay attention to the possibility of carcinogenesis. To sum up, the detection of abnormal AFP is not all liver cancer. The detection of a normal fetal protein can not absolutely exclude liver cancer.   The dynamic analysis of AFP was required, accompanied by B-super imaging examination. Liver cancer relationship editing a fetoprotein can be seen as a tumor signal, which means that the liver may have had liver cancer. In fact, the relationship between AFP and hepatocellular carcinoma can be used as an index to test liver cancer. However, there is no absolute relationship between the high and low levels of AFP and the size of liver cancer. The relationship between AFP and hepatocellular carcinoma There are two points to note: First, about one-third of small hepatocellular carcinoma will not rise, so a normal fetal protein does not mean that there is no liver cancer. Second, hepatitis itself can cause a slight rise in the AFP, and the rise of the AFP resulting from hepatitis, meaning that the damaged liver regenerates, rather than the simultaneous liver cancer. This type of hepatitis-induced increase in the number of AFP is generally within 400 (with the exception of course). It should be noted that when alanine transaminase and oxaloacetic transaminase decline, if the AFP does not follow the decline, it is necessary to consider the possibility of concurrent liver cancer. In addition, the maternal blood of the AFP value will be higher. The higher the AFP is, the greater the tumor does not indicate. However, if it is in the same patient, the high and low levels of the protein (compared to their previous values) can be used as an indicator of success or not, and whether there is a recurrence of the tumour.

AFP Test results

Parts	Disorders	Number of tests	AFP Positive number
Liver	Normal	15730	0
Pregnant women	1069	13	1.2
Hepatocellular carcinoma	868	589	68
Bile duct cancer	73	1	1.4
Non-cancerous liver disease	6484	15	0.2
Gonadal teratoma	108	4956
Non-sperm cell tumors	39	0	0
Chorionic carcinoma	15	2	13
Other tumors	13	1	0
Renal germ cell tumor of kidney	59	0	0
Neuro-mother Cell tumor	70	0	0
Other non-liver origin	1169	10	0.8
Other tumors	3371	1	0.03

AFP methyl fetal protein