The significance of alpha-fetoprotein detection for the diagnosis of liver cancer

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Alpha-fetoprotein (AFP) is a single-chain glycoprotein with a molecular weight of approximately 70,000. It is very similar in structure to albumin. AFP and albumin are the two main proteins in the fetal circulation. Many patients with liver disease will check the alpha-fetoprotein (AFP) value during the examination, so the increase in the alpha-fetoprotein value can be used to assist the detection of which diseases.

(1) Liver cancer is one of the common causes of high alpha-fetoprotein. Generally, the content of alpha-fetoprotein in the serum of normal people is less than 20μg/L, but when liver cells become cancerous, they resume the production of this protein It is understood that about 80% of liver cancer patients have elevated serum alpha-fetoprotein.

Usually 400μg/L is the standard. If the value is higher than this value, the possibility of liver cancer should be considered. Generally, alpha-fetoprotein has been elevated 8 months before the onset of symptoms of liver cancer, so patients with liver cirrhosis, chronic hepatitis, and patients with liver cancer in the family People should do regular inspections according to their own situation. Therefore, alpha-fetoprotein has certain significance for the early diagnosis of liver cancer.

One thing to remind is that it is not reliable to diagnose or rule out a disease only by using high alpha-fetoprotein indicators, because the discovery of liver cancer does not necessarily require high alpha-fetoprotein, and some liver cancers can have alpha-fetoprotein values. If it is normal, it should be combined with other serological examinations and comprehensive analysis of B-ultrasound, CT, PET-CT and other imaging examinations to increase the reliability of diagnosis.

(2) High levels of alpha-fetoprotein may be compared with non-malignant diseases such as acute and chronic hepatitis, severe hepatitis recovery period, liver cirrhosis, congenital biliary occlusion, malformed fetus and other alpha-fetoprotein, but the magnitude of the increase is compared Small, and the duration is relatively short.

(3) High levels of alpha-fetoprotein may be related to germ cell tumors. According to data, about 50% of patients with germ cell tumors are positive for alpha-fetoprotein (AFP); some other gastrointestinal tumors such as pancreatic cancer or lung cancer and Patients with liver cirrhosis may also have different degrees of high alpha-fetoprotein; in addition, male patients with alpha-fetoprotein greater than 25μg/L should also consider the possibility of testicular cancer.

(4) Viral hepatitis. Alpha-fetoprotein in the active phase of chronic hepatitis has mild to moderate increase, generally 50~300μg/L. The difference from hepatocellular carcinoma is that the increase is low, and generally does not continue to increase. After treatment, it decreases and even returns to normal.

(5) Neonatal hepatitis. Alpha-fetoprotein can be detected in 30% of neonatal hepatitis, and the incidence increases with the severity of the disease, most of which increase significantly. This can be differentiated from congenital biliary atresia, which is mostly normal for alpha-fetoprotein.

(6) Other reasons. Liver injury, ovarian cancer, pregnant women (3-6 months), congenital tyrosinopathy, testicular or ovarian embryonic tumors (such as seminoma, telangiectasia, ataxia, malignant teratoma, congestion Hepatomegaly, etc.) also often have increased alpha-fetoprotein.

Alpha-fetoprotein is a highly specific and sensitive tumor marker for primary liver cancer. Its Cutoff value (The cut-off value is the amount of the analyte tested, used to determine whether the result is higher or lower than the clinical or analytical decision point. The cut-off value setting gives a brief sensitivity and specificity Combination.) Generally, it is 20μg/L. When it is greater than 500mg/L or the content continues to rise, it is of definite significance.

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