Is elevated alpha-fetoprotein related to liver cancer? What role does alpha-fetoprotein play in the diagnosis of liver cancer?

Alpha-fetoprotein (AFP) is a special protein synthesized by fetal liver cells and normally present in fetal serum. It usually starts to rise after pregnancy, reaches its peak at 16 to 20 weeks of gestational age, then gradually decreases and disappears completely 1 to 5 weeks after the fetus is delivered.

In patients with primary liver cancer, the positive rate of AFP in serum often increases significantly, exceeding 350ng/ml, even reaching 1000ng/ml or increasing progressively. Therefore, clinicians often use AFP as an effective indicator for auxiliary diagnosis, efficacy assessment and prognosis of primary liver cancer. In the survey of primary liver cancer, AFP is the most commonly used method, which helps to detect early liver cancer, enable patients to receive early treatment and improve prognosis.

However, elevated AFP does not necessarily indicate liver cancer. AFP is a special protein during the development of liver cells, so in acute and chronic hepatitis and cirrhosis, along with liver repair and liver cell regeneration, AFP can also be produced and secreted, and serum AFP will also increase, but usually only slightly (less than 350ng/ml), and this AFP increase is not necessarily a bad thing.

For example, when a patient is diagnosed with severe hepatitis, the AFP level in the serum increases, which often indicates active liver cell regeneration, a higher survival rate after rescue than those with negative AFP, and a good prognosis. With the recovery of the disease, the AFP level often decreases gradually and returns to normal in dynamic observation. AFP may also increase after the use of some drugs that stimulate liver cell regeneration (such as hepatocyte growth factor). If the AFP level of patients with chronic hepatitis and cirrhosis remains high for a long time, remains high, or even increases progressively, they should be alert to the occurrence of primary liver cancer.

In addition to liver disease, patients with reproductive system embryonic tumors such as testicular cancer, ovarian teratoma, digestive tract tumors, and pancreatic cancer with liver metastasis often have elevated AFP. Elevated AFP can also be seen occasionally after acute massive blood loss.