Were you looking for AFP Maternal, ordered during pregnancy?
At a Glance
Why Get Tested?
When to Get Tested?
When your doctor suspects that you have certain cancers of the liver, testes, or ovaries; at intervals during and after treatment for one of these cancers; sometimes when you have chronic hepatitis or cirrhosis
A blood sample drawn from a vein in the arm
Test Preparation Needed?
The Test Sample
What is being tested?
This test measures alpha-fetoprotein (AFP) in the blood. AFP is a protein produced primarily by fetal liver and the portion of a developing embryo that is similar to the yolk cavity in bird eggs (yolk sac tissues). AFP concentrations are typically elevated when a baby is born and then decline rapidly. In healthy children and non-pregnant adults, AFP is normally only detectable at very low levels.
Liver damage and certain cancers can increase AFP concentrations significantly. AFP is produced whenever liver cells are regenerating. With chronic liver diseases, such as hepatitis and cirrhosis, AFP may be chronically elevated. Very high concentrations of AFP may be produced by certain tumors. This characteristic makes the AFP test useful as a tumor marker. Increased amounts of AFP are found in many people with a type of liver cancer called hepatocellular carcinoma and in a liver cancer occurring in infants called hepatoblastoma. They are also found in some people with cancers of the testes and ovaries.
AFP exists in several different variants. Traditionally, when a doctor orders an AFP test, it is for a total AFP, one that measures all of the AFP variants together. This is the primary AFP test in the United States.
One of the variants is called L3 because of its ability, in the laboratory, to bind to a particular protein called Lens culinaris agglutinin. The AFP-L3% test is a relatively new test that compares the amount of AFP-L3 to the total amount of AFP. An increase in the percentage of L3 is associated with increased risk of developing hepatocellular carcinoma in the near future and of having a poorer prognosis, as the L3-related cancers tend to be more aggressive. The AFP-L3% test is being ordered by a few doctors in the U.S. and is in wider use in some other countries, such as Japan.
How is the sample collected for testing?
A blood sample is taken by needle from a vein in the arm.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
No test preparation is needed.
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Sources Used in Current Review
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Grenache, D. and Jarboe, E. (Updated 2011 May). Hepatocellular Carcinoma. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/HepatocellularCarcinoma.html?client_ID=LTD through http://www.arupconsult.com. Accessed October 2012.
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Pagana, K. D. & Pagana, T. J. (© 2011). Mosby's Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 42-44.
Clarke, W., Editor (© 2011). Contemporary Practice in Clinical Chemistry 2nd Edition: AACC Press, Washington, DC. Pp 486, 496, 499.
(January 2011) Bruix J, Sherman M. Management of Hepatocellular Carcinoma. American Association for the Study of Liver Diseases Practice Guideline. Hepatology Vol. 53, No. 3, 2011. PDF available for download at http://www.aasld.org/practiceguidelines/documents/bookmarked%20practice%20guidelines/hccupdate2010.pdf through http://www.aasld.org. Accessed November 2012.
(December 2011) Llovet J, et al. Clinical Practice Guidelines: Management of hepatocellular carcinoma. European Association for the Study of the Liver and European Organisation for Research and Treatment of Cancer. Journal of Hepatology 2012 vol. 56 j 908–943. PDF available for download at http://www.easl.eu/assets/application/files/d38c7689f123edf_file.pdf through http://www.easl.eu. Accessed November 2012.
Sources Used in Previous Reviews
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Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.
Sherman, M. (2005 June 23). Hepatocellular Carcinoma: Epidemiology, Risk Factors, and Screening. Medscape, from Semin Liver Dis. 2005;25(2):143-154 [On-line information]. Available online at http://www.medscape.com/viewarticle/506830 through http://www.medscape.com.
(2005 January 05). LBA AFP-L3. Wako [On-line package insert]. PDF available for download at http://liver.wakousa.com/pdfs/packageinsert.pdf through http://liver.wakousa.com.
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Grund, S. (2004 August 10, Updated). Hepatocellular Carcinoma. MedlinePlus, Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000280.htm.
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Wako Diagnostics Receives the FDA Approval for a New Biomarker for Liver Cancer. Press Release, Richmond VA USA -- Medical Industry E-mail News Service(TM) -- June 21, 2005.
Pagana, K. D. & Pagana, T. J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 47-49.
Clarke, W. and Dufour, D. R., Editors (© 2006). Contemporary Practice in Clinical Chemistry: AACC Press, Washington, DC. Pp 271-272.
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(2007 November). AFP-L3% in Serum (Includes Total Alpha Fetoprotein). ARUP Technical Bulletin [On-line information]. Available online through http://www.aruplab.com. Accessed May 2009.