What is the basis for diagnosing liver cancer with alpha-fetoprotein? Mainly these two points

Liver cancer is a malignant tumor of the liver, which can be divided into two categories: primary and secondary. Primary malignant liver tumors originate from the epithelial or mesenchymal tissue of the liver. The former is called primary liver cancer, which is a highly prevalent and extremely harmful malignant tumor in my country; the latter is called sarcoma, which is relatively rare compared with primary liver cancer. Secondary or metastatic liver cancer refers to malignant tumors originating from multiple organs throughout the body that invade the liver. It is generally common in liver metastases from malignant tumors of organs such as the stomach, bile duct, pancreas, colorectum, ovary, uterus, lung, and breast.

Alpha-fetoprotein (AFP) is a glycoprotein belonging to the albumin family, which is mainly synthesized by fetal liver cells and yolk sac. AFP is closely related to the occurrence and development of liver cancer and various tumors. It can be found in high concentrations in many tumors and can be used as a positive detection indicator for many tumors. At present, it is mainly used as a serum marker for primary liver cancer in clinical practice, and is used for the diagnosis and efficacy monitoring of primary liver cancer.

Serum alpha-fetoprotein (AFP) measurement is relatively specific for diagnosing this disease. If serum AFP is continuously ≥400μg/L by radioimmunoassay and pregnancy and active liver disease can be excluded, the diagnosis of liver cancer can be considered. Clinically, about 30% of liver cancer patients are AFP negative. If AFP isomers are detected at the same time, the positive rate can be significantly increased.

The basis for diagnosing liver cancer with alpha-fetoprotein is that alpha-fetoprotein generally remains above 200ug/L for 8 weeks or remains above 500ug/L for 4 weeks or gradually increases without decreasing. Surgeons believe that it is meaningful only when it remains above 400ug/L or when alpha-fetoprotein increases with each passing time. In addition, liver masses must be found in combination with imaging findings before diagnosis can be made. This is because alpha-fetoprotein can also increase in hepatitis, embryonal tumors, and pregnancy.