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Elevated alpha-fetoprotein refers to a state where alpha-fetoprotein levels are outside of the reference range. There are two categories of AFP tests: tests performed on serum (blood plasma), and tests performed on amniotic fluid. Tests performed on serum are further categorized by the reason for performing the test: maternal serum, adult tumor ...
Alpha-fetoprotein (AFP, α-fetoprotein; also sometimes called alpha-1-fetoprotein, alpha-fetoglobulin, or alpha fetal protein) is a protein [5] [6] that in humans is encoded by the AFP gene. [ 7 ] [ 8 ] The AFP gene is located on the q arm of chromosome 4 (4q13.3). [ 9 ]
In adults a normal amount of AFP is 0-40nng/mL and high levels of this can indicate diseases, cancer, and fetal defects. In pregnant people AFP levels rise at 14 weeks until 32 weeks, and range between 10 and 150 ng/mL in the middle of gestation. This is why AFP can be used alongside other tests as a tumor marker protein in adults. [12]
Second-trimester maternal serum screening (AFP screening, triple screen, quad screen, or penta screen) can check levels of alpha fetoprotein, β-hCG, inhibin-A, estriol, and h-hCG (hyperglycosolated hCG) in the woman's serum. The triple test measures serum levels of AFP, estriol, and beta-hCG, with a 70% sensitivity and 5% false-positive rate.
AFP: UE 3: hCG: Associated conditions: low: low: high: Down syndrome: low: low: low: trisomy 18 (Edward's syndrome) : high: n/a: n/a: neural tube defects (like spina bifida that may have associated increased levels of acetylcholinesterase in the amnionic fluid), omphalocele, gastroschisis, multiple gestation (like twins or triplets), or an underestimation of gestational age.
Spina bifida can usually be detected during the second trimester of pregnancy by fetal ultrasound. [59] Increased levels of maternal serum alpha-fetoprotein (MSAFP) should be followed up by two tests – an ultrasound of the fetal spine and amniocentesis of the mother's amniotic fluid (to test for alpha-fetoprotein and acetylcholinesterase).
As an example, Alpha-fetoprotein (AFP) testing is used to screen for a neural tube defect (NTD) during the second trimester of pregnancy. If the median AFP result at 16 weeks of gestation is 30 ng/mL and a pregnant woman's AFP result at that same gestational age is 60 ng/mL, then her MoM is equal to 60/30 = 2.0.
AFP-L3% is the standard for quantifying the L3 isoform of AFP in serum of high risk chronic liver disease (CLD) patients. Studies have shown that AFP-L3% test results of more than 10% can be indicative of early HCC [ citation needed ] or early nonseminomatous germ cell tumor .