Alphafetoprotein analysis. Alpha fetoprotein analysis is normal in women. Reasons for temporary increase in benign diseases

AFP stands for alpha-fetoprotein in tests. Its significance is important in making many diagnoses.

The corresponding analysis is especially often prescribed during pregnancy; it is needed to determine various pathologies in the development of the fetus. This study is also used to identify tumor processes in the human body.

To get accurate results, you should know how to properly prepare for the procedure. This article will also discuss the norms of the indicator and deviations from them.

Alpha fetoprotein: what is it?

This is a special protein synthesized by the liver and gastrointestinal tract of the embryo. This substance is first produced in the corpus luteum of the ovary, and from the second month it is produced by the fetus.

Alpha-fetoprotein helps protect the fetus from rejection by the mother. The concentration of AFP in a woman’s blood depends on the intrauterine development of the fetus and the duration of pregnancy. Its greatest significance is observed in the last months of pregnancy.

This protein performs important functions in the body of a pregnant woman:

• participates in the transportation of substances necessary for the development and growth of the fetus;
• ensures the formation of surfactant (a substance that coats the respiratory organs, which is necessary for the child to breathe after birth);
• normalizes pressure in the blood vessels of the fetus;
• prevents the impact of a woman's estrogen on the fetus.

AFP begins to enter the maternal blood in the second month of pregnancy as a result of absorption from the amniotic fluid. The substance penetrates into it when the fetus excretes urine.

What the analysis shows

AFP in the study shows defects in fetal development. Therefore, it must be determined during pregnancy.

This examination helps to identify oncological processes occurring in the human body, in particular, cancer of the glands of the reproductive system and liver.

Thus, the tumor marker AFP is often used when there is a suspicion of the presence of cancer cells in the body, as well as metastases.

Indications for the study

A blood test for AFP is prescribed in the following cases:

• women during pregnancy;
• if there is a suspicion of pathology of intrauterine development;
• if you suspect oncological processes in the liver (hepatocellular cancer or hepatoblastoma);
• when monitoring the course of cancer;
• to clarify or make a diagnosis.

It is especially important to donate blood for AFP to pregnant women in the following cases:

• if infertility has been diagnosed in the past, there have been miscarriages or miscarriages;
• when fertilized by a blood relative;
• if the parents have a hereditary disease or genetic disorder;
• when a woman had an x-ray taken in the first three months of pregnancy;
• if the pregnant woman took medications with a toxic effect on the embryo;
• when a woman is over 35 years old and this is her first child;
• if the pregnant woman was influenced by negative environmental factors.

When diagnosing tumor processes, it is important to combine this study with the determination of other tumor markers.

Preparing for analysis

To get a reliable and accurate result, you must follow the rules. Preparation for analysis consists of the following steps:

1. It is advisable to do the examination in the morning from seven to ten o'clock.
2. You are not allowed to eat food before donating blood. The interval between the last meal and the analysis should be at least eight hours.
3. It is not recommended to smoke for several hours before donating blood.
4. A few days before the study, you should not drink alcoholic beverages.
5. Eliminate psycho-emotional and physical stress before analysis.
6. Two weeks before the procedure, you should not take medications.
7. Do not eat spicy, fried, fatty or salty foods the day before donating blood.
8. You can drink water before the diagnosis, but no more than one glass.

Performing diagnostics

The study is conducted in a hospital setting. Venous blood is taken for this.

Treat the surface of the skin above the vein on top of the elbow with an antiseptic solution. After this, a tourniquet is applied closer to the shoulder. The vein is pierced with a regular sterile syringe and the required amount of blood is drawn into it.

The biological material is placed in a special tube with reagents. In the laboratory, blood (plasma or serum) is examined for AFP levels, the data obtained are compared with normal values, and the results are entered into a special form.

There are two methods for determining the AFP level:

1. Linked immunosorbent assay.
2. Immunochemical study.

In addition to the liquid component of blood (serum and plasma), other biological material can be used for diagnostics:

• bile;
• amniotic fluid;
• pleural fluid;
• cyst contents;
• ascitic fluid.

The results are interpreted by a qualified physician.

Normal indicators

The value of AFP in the blood depends on gender and age criteria.

In men and women

In adults, the rate usually does not exceed ten units per milliliter.

This indicator should be normal for women (non-pregnant) and men.

In children

In a child, before reaching the age of two, protein begins to decrease to an indicator that has no diagnostic values.

After two years, its level is already less than 10 micrograms per liter of blood.

In women when carrying a child

The norm by week during pregnancy is shown in the table below.

Thus, alpha-fetoprotein increases in a pregnant woman until the last month. It grows to its maximum between 31 and 34 weeks, after which its value slowly decreases, so the result is not informative.

Reasons for the high rate

A high AFP value is observed in the following pathological conditions:

• tumor processes in the bronchi and lungs;
• metastasis to the liver, gallbladder and pancreas;
• malignant breast tumor;
• colon and stomach cancer;
• Oncological diseases of the ovaries and cells.

An increased AFP value may indicate a malignant tumor of the stomach, liver, lungs, colon, breast or pancreas.

AFP may temporarily increase in the following conditions:

• viral hepatitis;
• hepatic hyperplasia;
• liver failure;
• liver cyst;
• alcohol dependence (if the liver is affected);
• cirrhosis;
• cholelithiasis;
• cholecystitis.

This protein may increase slightly during active hepatic regeneration, which is usually observed after the use of antiviral agents or antibacterial drugs.

In male patients, AFP increases in testicular cancer in 70 cases out of 100. This occurs especially often in the last stages of the disease, when metastasis has already begun.

If elevated AFP is detected, a diagnosis is not made immediately. It is clarified using research methods such as ultrasound diagnostics, MRI, histological analysis, CT.

Signs and Causes of Low Value

A decrease in AFP in the blood is taken into account only during pregnancy. In adults, a low value is the normal limit.

In a woman carrying a child, a low level can mean various pathological processes.

AFP deviations during pregnancy

In the blood of a pregnant woman, an increase in this substance may indicate the following fetal pathologies:

• necrotic changes in the liver (usually this occurs as a result of diseases of viral etiology that a woman suffers during pregnancy);
• kidney defects;
• nonunion of the abdominal cavity (gastroschisis);
• umbilical hernia;
• hydrocephalus;
• defects in the formation of the neural tube.

An elevated level also indicates multiple pregnancy. It may also indicate diabetes mellitus, severe gestosis, hypertension or excessive weight of the pregnant woman.

A decreased reading in a pregnant woman may indicate the following pathologies:

• hydatidiform mole;
• trisomy 21 or 18;
• intrauterine development disorder;
• fading of pregnancy;
• miscarriage.

In some cases, this result indicates a false pregnancy.

There are often errors in setting dates when fertilization occurs later than the estimated day. In such a situation, the AFP indicator is reduced.

If the test shows any abnormality in a pregnant woman, then a repeat test is prescribed. In addition, additional diagnostic methods are also needed, such as ultrasound and a blood test for progesterone or hCG.

Normalization of indicator level

To normalize the AFP value, it is necessary to conduct additional studies to make an accurate diagnosis.

Treatment depends on the pathological condition and its severity. In addition, the individual characteristics of the patient’s body are also taken into account.

If the cause of the deviations is malignant neoplasms, then chemotherapy, radiation and surgery are prescribed.

When an increase in AFP is caused by benign processes, drug therapy is used.

If the indicator deviates in pregnant women, methods for normalizing this substance in the blood depend on the main reason for the increase or decrease.

Thus, AFP is an important indicator during pregnancy, so during routine screenings its level must be checked.

Any deviation may indicate genetic disorders and pathologies of intrauterine development. This protein is considered a tumor marker, so the study is prescribed even if oncological processes are suspected. Methods for normalizing an indicator depend on the main reason for the deviation.

Liver cancer is one of the most insidious types of cancer, the survival rate for which, even with adequate and timely treatment, rarely exceeds 2-3 years from the moment of diagnosis. As medical statistics show, most patients seek medical help when the disease reaches stages 3-4, and there is an active process of metastasis to healthy organs and tissues. At the initial stage, liver cancer occurs without pronounced symptoms, but the appearance of certain signs should alert a person and become a reason for undergoing an examination. These may be digestive disorders, yellowness of the mucous membranes and skin, dull pain in the right hypochondrium.

One of the ways to early diagnose malignant tumors of the liver, as well as organs of the reproductive system (ovaries in women and testicles in men), is a blood test for the tumor marker AFP. Tumor markers of alpha-fetoprotein in small concentrations can be found in biological substances of people of any age, but during tumor processes their number increases several times, which makes it possible to suspect cancer and is a reason for conducting a comprehensive diagnosis. You should not immediately panic if the level of AFP tumor markers in the blood or urine exceeds the norm, since this clinical picture is also typical for benign tumors.

Alpha-fetoprotein is a molecular agent of a protein nature and synthesized by tumor cells from the moment of their appearance. AFP can be present in small quantities in the peripheral blood of adults and children, and can also be released by the fetus during pregnancy. If pregnancy proceeds without pathologies, the embryo begins to secrete alpha-fetoprotein, starting from the second week of its development. This protein is necessary for regulating the mother’s immunity, but despite this, in elevated concentrations it can be dangerous, since the cells of the woman’s immune system can mistake the developing fetus for a foreign body and launch an attack against it, which very often ends in miscarriage or spontaneous miscarriage .

To monitor AFP levels, women are prescribed a blood test, as well as screening, which must be performed 3 times during the entire gestation period. In exceptional cases, salivary secretions, bile or urine may be taken for examination, but such diagnostics are carried out according to strict medical indications.

In the body of other people, alpha-fetoprotein performs a protective function and promotes the release of enzymes that destroy cells of various tumors and formations, including malignant lesions of the lung tissue and liver.

Fact! In the vast majority of cases, an increased level of AFP tumor markers in the peripheral blood indicates liver tumor formations. You need to be especially careful when conducting diagnostics in pregnant women in order to detect clinical signs of true pathologies in time.

Normal values ​​in healthy people

AFP standards in some cases may be determined by the medical institution that performed the diagnostics and laboratory blood tests, but they should not differ greatly from generally accepted indicators. For women of reproductive age, this figure is usually 6.3-6.6 IU/ml. In men, a slight excess of AFP is allowed - up to 6.67 IU/ml. The same figure is the norm for elderly patients.

Normal in children

Table. Normal alpha-fetoprotein level in children.

Important! If the level of AFP tumor markers is significantly lower than normal or exceeds it, the patient requires a comprehensive examination to exclude malignant pathologies and other serious diseases. Diagnosis usually begins with an examination of the abdominal organs; in women, secondary diagnosis may also include examination of the pelvic organs.

Indicators are down - what does this mean?

Low levels of alpha-fetoprotein are detected primarily in pregnant women. In some cases, this is not a reason for concern, for example, with grade 2-3 obesity, AFP levels may be at the level of 5-5.5 IU, which can be considered a relative norm for this category of patients. Suffered injuries can also cause a temporary decrease in AFP, but in this case, a repeat test, which is prescribed for such a clinical picture 10-14 days after the previous one, should not reveal significant deviations from the permissible norm (for pregnant women it ranges from 15 to 250 IU /ml – depending on gestational age).

If a repeat analysis again shows that the AFP level does not correspond to the lower limits of the generally accepted norm, the doctor may suspect pathologies and diseases of the fetus, for example, Down syndrome or lacunar insufficiency of the placenta.

Important! A low level of AFP can also be a sign of intrauterine fetal death, since the cells of a living organism produce a sufficient amount of alpha-fetoprotein.

Elevated AFP and its role in the diagnosis of cancer

An increase in the AFP tumor marker in the blood is one of the main positive signs of cancer predisposition. Most often, such diagnostic results indicate malignant liver lesions, including not only the tumors themselves, but also metastases - distant secondary foci of the malignant process moving from the main focus through the body tissues. In women, a similar clinical picture may indicate tumors of the ovaries, uterus, and mammary glands. In men, a significant increase in alpha-fetoprotein often indicates testicular and prostate tumors.

One of the most dangerous diseases accompanied by an increase in AFP is squamous cell cancer of the esophagus and pancreas. Treatment of this form of cancer gives positive results only in 7-11% of cases, with a maximum survival prognosis of no more than 5 years.

An elevated AFP tumor marker may also indicate the following pathologies and diseases:

• partial dysfunction of the liver or dysfunction of its cells (liver failure);
• viral and alcoholic hepatitis;
• cirrhosis of any stage;
• inflammation of the gallbladder associated with blockage of its lumen by stones (cholelithiasis);
• fatty liver;
• hyperplasia of liver tissue and adenomas arising against this background.

A significant excess of normal levels of alpha-fetoprotein is also characteristic of cystic formations of the genitourinary system, therefore, in the absence of positive results after diagnosing the abdominal organs, the patient is prescribed a secondary diagnosis, including a comprehensive examination of the urinary tract, reproductive organs, bladder and ureters.

Tumor markers - laboratory indicators of tumors

Note! A temporary sharp increase in AFP and a positive test for the AFP tumor marker can be observed with long-term use of certain medications, the metabolism of which occurs in hepatocytes, as well as during exacerbations of cholelithiasis, cholecystitis and pancreatic diseases.

Analysis for AFP tumor marker during pregnancy

Measuring the level of alpha-fetoprotein in pregnant women is included in the screening program and has a different diagnostic value compared to patients at risk for cancer predisposition. Deviations from the norm at different stages of gestation may be a sign of fetal pathologies or complications during pregnancy. Most often, this picture is observed in the following diseases and pathologies:

• risk of miscarriage;
• fetal death and intrauterine death;
• congenital umbilical hernia of the fetus;
• severe pathologies of the brain and bone marrow in a child (the most severe and rare disease is anencephaly - the absence of the brain or part of it);
• disturbance in the formation of kidneys and bone tissue;
• autoimmune disorders.

If an analysis for an AFP tumor marker in a pregnant woman reveals a significant excess from the permissible norm, the overall clinical picture should be assessed based on a combination of other diagnostic indicators. In most cases, the expectant mother is offered to undergo amniocentesis, a prenatal invasive diagnostic method that involves puncturing the amniotic membrane and collecting amniotic fluid for laboratory testing.

Despite the high risks of miscarriage after this procedure, this method remains the only reliable way to detect congenital anomalies and pathologies of fetal development before birth. If an examination of the amniotic fluid reveals malformations that are incompatible with future life and significantly reduce its quality, the woman may be advised to terminate the pregnancy.

Note! Increased levels of tumor markers alpha-fetoprotein in the peripheral blood can be observed during multiple pregnancies. If other diagnostic methods have not revealed any abnormalities, this option is considered normal.

How is the analysis carried out and how to prepare for it?

In most cases, venous blood is taken for testing. The analysis is carried out in the morning - within 3-4 hours after waking up. It is necessary to donate blood on an empty stomach; the last meal should be no later than 22:00 the day before the test. For dinner, it is better to choose low-fat, easily digestible foods, for example, milk porridge or vegetable casserole. You should also avoid spicy, salty, smoked and pickled foods, which create an increased load on liver cells and can affect the reliability of the analysis.

To ensure that the result is as accurate as possible, the doctor also advises following certain preparation recommendations.

1. If a person is taking any medications, it is necessary to consult with a doctor about stopping them 2 weeks before the test. If this is not possible, you should definitely warn the laboratory technician about which medications the patient is taking and in what daily dosage.
2. On the day of the test, it is better not to brush your teeth or smoke.
3. Three days before the test, you should limit physical activity, especially if it involves lifting heavy objects.
4. If a person suffers from type 1 diabetes mellitus, it is necessary to make an appropriate note on the form with a transcript of the analysis, since synthetic insulin reduces the concentration of alpha-fetoprotein in the blood.

If a woman is pregnant, this should also be reported to the specialist conducting the study. The expectant mother must also accurately state the duration of her pregnancy and report all medications that she took in the two weeks before the test (including vitamin supplements).

Treatment options with alpha-fetoprotein

AFP is an important diagnostic indicator of the functioning of many internal organs and a possible tumor process in the body, but it can be used not only to identify, but also to treat certain diseases. Alpha-fetoprotein therapy is widely used for uterine fibroids, a benign tumor of the muscular layer of the uterus, which can have a diffuse or nodular structure. Once in the blood, the protein attacks tumor cells, destroys them and inhibits the re-growth of the tumor. Urologists often prescribe AFP as part of combination therapy in the treatment of infectious diseases of the urogenital tract in women and men in order to increase the effectiveness of treatment and stimulate immune activity.

Other indications for the use of alpha-fetoprotein may include:

• diabetes;
• severe damage to the respiratory system (for example, bronchial asthma);
• cystic fibrosis;
• arthritis and other autoimmune disorders;
• peptic ulcer, etc.

Alpha-fetoprotein preparations are quite expensive, but their use is justified by their stable therapeutic effect. They have a powerful immunomodulatory effect and can be part of combined treatment regimens for various types of cancer in patients of any age. Tolerability of the drug is quite good, but in some cases individual reactions may occur that are not associated with allergies or intolerances: hyperthermia (increased temperature above the limits of subfebrility), a feeling of heat, skin reactions.

Patients receiving alpha-fetoprotein preparations as an adjuvant therapy for malignant tumors of the liver, kidneys, intestines and mammary glands may develop endotoxicosis - the release of toxins into the blood and lymphatic environment (endogenous intoxication). To normalize well-being, sorbents and anti-inflammatory drugs from the NSAID group are prescribed.

AFP tumor marker is one of the main diagnostic indicators that allows identifying signs of cancer in the early stages. People at risk for developing various types of cancer are recommended to be screened for tumor markers at least once a year. In most clinics this can be done for free. study at the link.

Video - Three tests for liver disease

The tumor marker alphafetoprotein is a two-component protein (glycoprotein) that is produced by the gall sac, intestinal epithelium and embryonic liver. The tumor marker produced by the cells of the embryo is very important for it, because AFP for the fetus is similar to albumin for an adult. It performs the following functions:

1. Transports molecules;
2. Protects the fetus from the negative effects of the pregnant woman’s immune system;
3. Controls the influence of a woman’s estrogen on the development of the child.

Without this protein, full-fledged oncogenesis of the baby is impossible. However, in an adult, AFP can also be elevated due to cancer of the breast, pancreas or liver, since malignant cells can be similar to embryonic ones.

What is AFP

What is the tumor marker AFP is necessary to know, because the level of fetoprotein can increase slightly not only during malignant neoplasms, the growth of the tumor marker can also increase due to some pathologies of different organs. In oncology, AFP (Alpha Fetoprotein) is considered a tumor marker for tumors in the breast, liver and pancreas. Unlike other tumor markers, the level of AFP does not depend on the stage of the pathology, the degree of its malignancy and the size of the tumor, therefore, in case of cancer, the study is necessarily supplemented with other diagnostic measures.

The duration of pregnancy and the amount of AFP directly depend on each other. The largest amount of this protein in a child's body is produced at the thirteenth week after fertilization, and in a woman's body, the concentration of alpha-fetoprotein begins to increase at ten weeks of pregnancy, reaching a maximum in the period from thirty to thirty-two weeks. Until a year after birth, the level of alpha fetoprotein in the baby's blood drops to zero.

Using an AFP test in combination with a blood test for human chorionic hormone (hCG), doctors identify fetal abnormalities and pathologies that may be present during fetal development, as well as gene mutations. During research, it is necessary to know the most accurate gestational age possible, since at different stages there may be low and high concentrations of AFP. A blood test for tumor markers helps assess the quality of treatment and the chances of five-year survival.

Indications for the study

AFP tumor marker testing is carried out for both pregnant and non-pregnant women. What the tumor marker shows in a particular case can be found out below. In women who are not pregnant, an increase in AFP can be caused by a number of the following reasons:

• tumor in the ovaries:
• primary neoplasm in the liver;
• squamous cell carcinoma of the esophagus;
• breast cancer;
• metastasis of the oncological process to other organs.

The cause may also be a benign tumor. Taking an AFP test is necessary not only for diagnosing the disease, but also for monitoring the development of the disease, as well as monitoring the effectiveness of the treatment.

Pregnant women should undergo laboratory tests in order to promptly identify possible abnormalities in the development of the fetus. Mandatory indications for taking blood and testing it for AFP levels are:

• a woman has a child with any developmental defect, as well as chromosomal mutations (for example, Down syndrome);
• history of miscarriages or pregnancy after infertility treatment;
• the birth of a dead child to a pregnant woman in the past.

Early diagnosis of fetal pathologies using AFP allows one to make a timely decision to terminate the pregnancy or to prepare for the treatment and education of a child with a congenital disease if the woman decides to continue the pregnancy.

When performing an analysis for a tumor marker, it is necessary to accurately determine the gestational age, since at different stages of fetal development the level of AFP will be different.

How to prepare for this test

Blood for testing is taken from a vein. In order for the result to be as reliable as possible, it is necessary to take the right approach to testing for the AFP tumor marker:

• donate blood in the morning on an empty stomach;
• one day before blood sampling, you should give up fatty, smoked and seasoned foods, and eight hours before the test - from food in general;
• on the eve of the study, you should not overwork yourself physically and emotionally;
• It is forbidden to drink alcoholic beverages several days before the test;
• It is better not to smoke for several hours before testing for AFP and not to take medications (if it is impossible to exclude taking medications, you must inform the laboratory assistant about the time, dose and name of the medication taken);
• Water can be drunk in unlimited quantities before analysis.

As you can see, there are no serious restrictions, and compliance with the rules described above will allow the results to be correct.

Decoding the results

You should not try to decipher the research results yourself. Deciphering AFP tumor markers should be done by a highly qualified specialist; only he knows exactly when the level of this protein increases or decreases. As a rule, in a public clinic it can take up to three days to decipher the result, while in private clinics the result will be ready within 24 hours. The tumor marker level in different laboratories can be measured in IU/ml or ng/ml.

Normal value for the tumor marker alphafetoprotein

Thanks to solid-phase chemiluminescent enzyme-linked immunosorbent assay, normal values ​​can be determined. The norm depends on age and gender. On analysis in men, normal values ​​will be as follows (in IU/mg of blood):

• up to one month - 0.5 - 13600;
• from one month to one year - 0.5 - 23.5;
• after a year - 0.9 - 6.67.

In women, the AFP norm is as follows:

• up to one month - 0.5 - 15740;
• from one month to one year - 0.5 - 64.3;
• after a year and in adults in the absence of pregnancy - 0.9 - 6.67.

In pregnant women, the tumor marker rate depends on the length of pregnancy in weeks:

• 1-12 - 0,5 -15;
• 12-15 - 15 - 60;
• 15-19 - 15 - 95;
• 19-24 - 27 - 125;
• 24-28 - 52 - 140;
• 28-30 - 67 - 150;
• 30-32 - 100 - 250.

In different laboratories, normal values ​​may vary slightly. If the analysis shows that there is more AFP in the blood than normal, you need to see a doctor and undergo a full examination, including ultrasound, magnetic resonance imaging, radiography, and a blood test for other tumor markers. Do not forget that during pregnancy some diagnostic measures may be contraindicated.

Level exceeding normal

An increase in AFP in non-pregnant women in ninety percent of cases means liver cancer, in ten percent the occurrence of metastases, ovarian cancer, malignant neoplasms in the mammary or pancreas, intestines, and lungs. In addition to oncological pathologies, an increase in tumor markers sometimes indicates biliary cirrhosis, exacerbation of chronic hepatitis, liver dysfunction due to alcoholism, surgical or mechanical injuries to the liver, as well as the development of Wiskott-Aldrich syndrome.

If AFP is elevated in a woman during pregnancy, this indicates in eighty-five percent that there is some kind of anomaly in the formation of the neural tube of the embryo. Also, an increase in tumor marker can be an indicator of cancer in the fetus, mutations in the organs of the urinary system, absence of kidneys, intestines, or esophagus. The tumor marker may increase if there is a threat of spontaneous abortion, pathologies of the placenta, or if the formation of the skeletal system in the fetus is imperfect.

Reduced rate

A decrease in this protein in the blood can occur due to gene mutations in the embryo, for example, with Patau, Edwards, or Down syndrome. In a pregnant woman, AFP may fall if the pregnancy is frozen and the child dies, as well as with abnormal growth of the chorionic villi filled with amniotic fluid (this pathology leads to the arrest of fetal development). If a pregnant woman is severely obese or has diabetes, the tumor marker level also drops.

What can affect the results?

As a rule, people with black skin have a higher level of AFP in their blood than people with light skin. The level can be affected by endocrine diseases, as well as multiple pregnancies. An increase or decrease in this tumor marker is not a reason for independent diagnosis and self-treatment. The examination and treatment plan should be drawn up exclusively by the doctor.

Early detection of tumor markers makes it possible to maximally assess the advanced stage of the disease and track the dynamics of the disease against the background of treatment. One of the tumor markers is alpha-fetoprotein, or AFP.

Description

Alpha fetoprotein is a glycoprotein or protein whose peptide part is combined with oligosaccharides. In oncology, this criterion is quite widely used in the diagnosis of carcinoma of the breast, ovaries, pancreas and liver. Of course, a deviation of alpha-fetoprotein from normal values ​​does not mean that a person has cancer, but this fact serves as a mandatory reason for prescribing a more extensive diagnosis of a person.

In a healthy body, this tumor marker can be found in residual quantities or completely absent. The exception is pregnant women, in whom alpha-fetoprotein is produced by the developing fetus and its titer is used to judge possible gestational pathologies.

A slight increase in AFP in humans may indicate pathological processes of a systemic nature, for example, inflammation of the pancreas, various types of infections. If the tumor marker titer exceeds all conceivable norms several times, most likely we are talking about developing oncology.

The relationship between the size of the tumor and the degree of its malignancy and the level of AFP has not been established. Therefore, studies are carried out to not only indicate a possible diagnosis, but also to assess the chances of survival and cure of the patient.

Indications for the study

If a woman is not pregnant, a test for the tumor marker alpha-fetoprotein will confirm or refute malignant lesions of the ovaries, mammary glands, pancreas, esophagus, liver and metastases in the body.

Also included in the list of indications for diagnosing AFP are benign neoplasms and screening that studies the effectiveness of treatment for cancer, for example, after surgical resection of a tumor.

During pregnancy, every woman is given an alpha-fetoprotein test. It makes it possible to promptly identify gross anomalies in the development of the unborn child. Particular attention is required in this matter for women who have in the past experienced spontaneous abortions, stillbirths, or the birth of children with serious genetic disorders and developmental anomalies.

Norm

Consider below the norms for men and non-pregnant women in the following table.

For pregnant women, there are separate reference values, the norms of which are listed in the following table.

Decoding

The AFP results are assessed in the same laboratory where the patient donated blood for testing. When deciphering the analysis, the standards that are officially adopted by the diagnostic institution are taken into account. For this reason, alpha-fetoprotein reference values ​​may differ from one laboratory to another.

In the blood of a healthy person, regardless of gender, the AFP norm is 0-10 IU/ml. If its readings are above 400 IU/ml, we are most likely talking about an oncological process in the body. But even if AFP increases from 10 IU/ml, many patients begin to sound the alarm. Most often this problem concerns expectant mothers.

Why might AFP concentrations increase?

• Liver cancer - 90%.
• Cancer of the reproductive organs in men and women.
• Metastases - 10%.
• Lung and gastrointestinal cancer.
• Exacerbation of hepatitis - the level of AFP in this case increases temporarily.
• Biliary cirrhosis.
• Liver diseases associated with alcohol dependence.
• Liver injuries of a mechanical or surgical nature.

If an increase in AFP is detected in a pregnant woman, the analysis may show:

• Pathologies of the neural tube of the fetus - 85%.
• Anomalies in the formation of the urinary tract in the unborn child - absence of kidneys, obstruction of the ureter, etc.
• Problems with the digestive tract - underdevelopment of the intestines or esophagus, their infection.
• High risk of spontaneous abortion or premature labor.
• Deviations in the condition of the placenta.
• A disorder of bone formation in the embryo, for example, “crystal disease.”

Also, in expectant mothers, a reduced level of AFP is taken into account. If the concentration of a tumor marker does not correspond to the reference values, falling short of normal, this may indicate the following problems:

• Serious chromosomal abnormalities - Down syndrome.
• Fading of pregnancy, death of the embryo.
• Hydatidiform mole, proliferation of the chorion, cessation of development of the fertilized egg.
• A woman is overweight.

Low AFP in pregnant women may also be due to an error in their due date. If conception occurred later than expected, then inaccuracies in the measurement of alpha-fetoprotein cannot be ruled out.

When the level of AFP decreases to normal criteria during antitumor therapy, we are talking about the right choice of treatment tactics and its effectiveness, as well as a favorable prognosis for recovery.

Otherwise, if treatment has been started, but AFP does not “think” of decreasing, complications most likely have arisen - secondary cancer foci or metastases, or a relapse of the malignant process.

In order for the results of the study to be as accurate as possible, it is important to properly prepare for them. Before taking a blood test for alpha-fetoprotein, which can indicate malignant tumors in the body, the following requirements must be met:

• a day before diagnosis, stop eating fatty and smoked foods, as well as alcoholic beverages;
• on the eve of the study, avoid psycho-emotional shocks and physical exertion in every possible way;

• 8 hours before the test, do not take medications containing B vitamins;
• You cannot eat at least 4 hours before visiting the laboratory;
• 30 minutes before collecting biological material, avoid smoking.

How is the analysis performed?

To conduct the study, it is necessary to take the patient’s venous blood. To determine the concentration of alpha-fetoprotein, the so-called Tatarinov-Abelev reaction or AFP test is used. The technique is based on the study of fetal serum globulin using agar.

Diagnostic results depend on proper preparation of the patient before blood sampling.

Do I need to take tests again to confirm?

If the test is prescribed by a doctor, and the recommendations for preparing and donating blood are followed, the diagnostic results are accurate. In the case of a primary increase in alpha-fetoprotein levels, most doctors prescribe the test again to eliminate the possibility of a laboratory error and begin comprehensive screening if problems in the body are confirmed.

Special conditions affecting marker levels

The results of diagnosing alpha-fetoprotein can be influenced by various factors. We list them in the following table.

Conditions	Description
RACE OF A PERSON	Representatives of the Negroid race have increased AFP values ​​in the blood compared to the norm, while representatives of the Mongoloid race, on the contrary, have decreased values.
MULTIPLE PREGNANCY	In an expectant mother, a discrepancy between AFP values ​​and the norm valid for the gestation period may indicate the development of not one, but two or more fetuses.
ENDOCRINE DISEASES	In pathologies such as diabetes mellitus and inflammation of the thyroid gland, the level of AFP will deviate slightly from generally accepted values.
KIDNEY AND LIVER DISEASES	Renal failure, urinary tract disorders, hepatitis and cirrhosis of the liver can cause an increase in the concentration of AFP in the body.
DOWN SYNDROME IN AN UNBORN CHILD	If a woman is pregnant and has a low level of AFP, doctors have every reason to suspect this diagnosis in the unborn baby.

Features of testing for children, pregnant and lactating women, the elderly

There are no specific differences in the analysis and reference values ​​for small and adult patients, except for pregnant women and infants. The value of alpha-fetoprotein is the same for everyone, and if deviations from the norm occur, this fact cannot be ignored.

Where can tests be done?

It is recommended to take an alpha-fetoprotein test in the same laboratory, which uses an identical test method. If the patient begins to recheck the marker in different diagnostic institutions, he may encounter some discrepancies in the AFP assessment, which will complicate the diagnosis.

Let's consider medical centers where you can get an AFP test.

• Clinic "Miracle Doctor", st. Shkolnaya, 11. Cost 430 rubles.
• Medical center "SM-Clinic", st. Klara Zetkin, 33/28. Cost 560 rub.
• Clinic "Spectra", st. G. Kurina, 16. Cost 655 rubles.

Saint Petersburg:

• Clinic "Family Doctor", st. Academician Pavlova, 5. Cost 500 rubles.
• Medical center "IntraMed", st. Savushkina, 143. Cost 540 rubles.

In other cities of Russia, you can get tested for alpha-fetoprotein in laboratories of the Invitro network. The price for the study depends on the specific region. Let's take a look at some clinics.

• Kazan, st. Vishnevsky, 29/48. Cost 300 rub.
• Saratov, st. Tarkhova, 29. Price 320 rubles.
• Arkhangelsk, Lomonosov Ave., 13. Cost 360 rubles.

In addition to the cost for laboratory testing, it is important to take into account that in addition in the listed clinics, in particular in the Invitro network, a certain amount is charged for collecting venous blood, equal to 150-180 rubles.

Analysis of alpha-fetoprotein levels can show various serious abnormalities. In the case when the AFP level differs from the norm, that is, it is elevated, this is not a reason to panic, since it can indicate not only oncology and abnormalities in expectant mothers, but also inflammatory changes in the body, as well as benign tumors.

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Tests for tumor markers make it possible to determine the presence of cancerous tumors at a very early stage of development. Alpha protein or AFP is a tumor marker produced mainly by tumors formed in the abdominal organs. In the body of a healthy person it is completely absent or present as traces.

AFP tumor marker is a fetoprotein, the first type - it is produced directly by cancer cells and penetrates into the systemic bloodstream and other biological fluids, where its amount can be detected using laboratory tests.

Alpha-fetoprotein is produced in embryonic cells and enters the bloodstream of a pregnant woman. The amount of tumor marker AFP directly depends on the duration of pregnancy; its indicators can be used to determine how the fetus develops and whether genetic abnormalities are present.

The role of AFP in the fetus is to perform transport functions, control the influence of maternal estrogen and protect the fetus from the mother’s immunity. A normal amount of fetoprotein allows you to maintain pregnancy, protecting the fetus from attacks by the pregnant woman’s immune system, which considers it a foreign substance.

After the birth of a child, the amount of tumor markers decreases and by one year approaches the levels corresponding to an adult. Further AFP synthesis can continue in hepatocytes.

The tumor marker AFP is released in increased quantities when malignant and benign tumors develop in the body. Its antitumor properties allow it to slow down tumor growth by destroying cancer cells. Most often, a high amount of tumor marker indicates liver cancer or other inflammatory pathologies in the liver or bile ducts.

The AFP tumor marker also increases in other cancers, so it can be used to detect gastrointestinal, breast and genitourinary cancers. But for a more accurate diagnosis, alpha-fetoprotein is examined simultaneously with the level of hCG and estrogen hormones.

Indications for testing

A blood test for the tumor marker AFP is a specific test that is prescribed only for strict indications. Pregnant women undergo screening - a study that includes identifying the level of AFP and ultrasound. Monitoring fetoprotein levels allows for timely detection of abnormalities in fetal development.

Indications for determining AFP levels in pregnant women:

• pregnancy after a long period of infertility;
• miscarriages, birth of children with anomalies, history of threatened miscarriage;
• previous stillbirth;
• parents' age over 35 years;
• presence of genetic diseases in the family.

Men and non-pregnant women are prescribed to donate blood for tumor marker levels in the following situations:

• , reproductive organs;
• differentiation of malignant and benign tumors;
• tracking dynamics after treatment and surgical removal of the tumor;
• early detection of relapse and spread of metastases.

It is very difficult to suspect the presence of cancer in the early stages of development, therefore, if any alarming symptoms appear, it is necessary to undergo a full diagnosis.

Symptoms that require determination of the tumor marker AFP in the blood:

• yellowness of the eyes and skin;
• liver enlargement;
• causeless nausea;
• sudden weight gain or loss;
• lump in the chest;
• black or bloody stools;
• constant weakness.

When referring an oncologist for examination, he can simultaneously order examinations of others in order to obtain a more accurate picture of the oncological disease.

Preparation and delivery of analysis for AFP

To get the most informative analysis, you need to properly prepare for the tests.

Preparation rules:

1. Quit cigarettes on the day of the study.
2. Avoid spicy, fatty, salty foods, as well as spices, smoked meats and marinades.
3. Completely eliminate alcohol, energy drinks and carbonated drinks 2-3 days before the test.
4. Do not take any medications several days before blood collection.
5. Avoid physical activity the day before the test: running, lifting weights, swimming, intimacy.
6. Avoid stressful situations and nervous tension.

Blood for tumor markers is taken strictly on an empty stomach from a vein. It is best to donate blood in the morning, and you can only drink a little clean water. Results can be obtained the very next day, or at most within three days.

AFP tumor marker, its interpretation, indicators of norms and deviations in men and women

Independent deciphering of the AFP tumor marker and further self-medication is categorically unacceptable. Indicators may depend on various factors, so auxiliary examination methods are necessary to make a diagnosis.

Attention! Blood tests can be carried out using enzyme immunoassay or immunochemical methods. Therefore, to track dynamics, you need to get tested in the same laboratory or use the same research method.

The normal level of the tumor marker AFP in women of reproductive age is 6.3-6.6 IU/ml. In men and women of retirement age, the rate rises to 6.7 IU/ml. Which will not be a pathology. If the amount of AFP is measured in ng/ml, then the normal level of the marker in men and women is less than 13.4 ng/ml.

A tumor marker deviation from the norm may indicate both malignant neoplasms in internal organs and benign neoplasms, often multiple.

If the level of AFP is elevated, doctors prescribe additional examinations to identify the location of the tumor, its type and predict the further course of the disease.

Indicators of norms and deviations of AFP tumor marker in children

Since the tumor marker AFP is produced by embryonic cells, its high level in a newborn child is a pattern. Moreover, in boys, the concentration of the tumor marker in the blood is slightly lower than in girls.

The normal level of AFP tumor marker in newborns is:

1. boys - up to 13600 IU/mg;
2. girls – up to 15740 IU/mg..

Immediately after birth, the concentration of fetoprotein gradually decreases and after the first month of life the norm for girls is 0.5-64.3 IU/mg, and for boys up to 23.5 IU/mg. After a year, the tumor marker norm approaches that of an adult – up to 6.7 IU/mg.

Children are tested if there is a suspicion of cancer, genetic mutations or congenital developmental disorders. Determination of the amount of tumor marker is necessary if the mother had too high or too low an AFP level during pregnancy to confirm or refute the preliminary diagnosis.

Testing during pregnancy: indicators and their interpretation

AFP levels in pregnant women constantly change depending on the duration of pregnancy. If the concentration of the tumor marker is within normal limits, then it is considered that the pregnancy proceeds without complications and without the threat of the development of intrauterine anomalies.

The AFP test is included in triple screening, since alpha-fetoprotein alone is not sufficiently informative. Therefore, it is examined simultaneously with the hCG hormone, and with the help of ultrasound, the gestational age is confirmed and the general condition of the fetus is determined.

Triple screening is most informative if carried out between 12 and 16 weeks. The recommended examination period is 13 weeks; it is most informative if you undergo an ultrasound on the same day.

Tumor marker norm by week of pregnancy in IU/mg:

WEEKS	AVERAGE VALUE	NORMAL AFP IN IU/mg.
From 1 to 12	-	Up to 15
13	19	15-25
14	24	15-30
15	29	15-60
16	33	17-65
17	38	19-75
18	43	22-85
19	48	22-95
20	53	27-105
21	58	32-110
22	63	37-115
23	68	42-120
24	73	47-125
25	78	52-130
26	83	57-135
27	88	62-140
28	93	67-145
29	98	72-150
30	103	77-155
31-32	140	100-250

The level of alpha protein begins to increase as soon as conception occurs - it is initially secreted by the yellow sac, but after the 5th week of pregnancy the fetus takes over this function.

Attention! The concentration of AFP simultaneously increases in both the maternal and fetal blood. Therefore, for the study, it is enough to take blood from a pregnant woman.

1-1.5 months before birth, at approximately 32 weeks of pregnancy, the concentration of fetoprotein begins to decrease, but is still at a fairly high level. After birth, the level of AFP in the child’s blood gradually decreases and returns to normal after the first year of life.

Reasons for increasing and decreasing tumor markers

Normally, alpha-fetoprotein is completely absent in the adult body or is present in traces. If the tumor marker AFP is elevated, one may suspect that malignant processes are occurring in the body.

In almost all cases, a high AFP tumor marker in women indicates that a tumor has formed in the liver or organs of the reproductive system. Also, a deviation from the norm to a greater extent may indicate other cancers, but in order to make an accurate diagnosis, a complete examination of the body is performed.

Most often, an elevated AFP tumor marker in men indicates that the liver is affected. These can be malignant and benign tumors, inflammatory processes, sclerotic lesions.

Attention! An increase in tumor markers is possible due to frequent alcohol consumption if the functioning of the liver is impaired.

The main reasons for the increase in AFP can be identified:

1. Liver carcinoma.
2. Gastrointestinal cancer.
3. mammary glands.
4. Benign neoplasms of the abdominal cavity.
5. Acute course of hepatitis.
6. Cirrhosis of the liver.
7. Traumatic liver damage.
8. Blockage of bile ducts.
9. Hereditary tyrosinemia.
10. Telangiectasia.

The AFP tumor marker increases if the malignant tumor has metastasized or a relapse of the disease occurs after removal or irradiation. In any case, it is necessary to undergo additional tests and undergo ultrasound, radiography and computed tomography in order to accurately identify the cause of high alpha protein.

If the tumor marker AFP is elevated in a pregnant woman, she is referred for consultation with a geneticist. After comparing the test results and ultrasound examination, the doctor tells the woman about the possible risks.

What does high concentration mean:

• improperly laid neural tube in the fetus;
• abnormal development of the fetal genitourinary organs;
• absence of digestive organs in the embryo;
• high risk of miscarriage or premature birth;
• disruption of the placenta;
• immaturity of the skeletal system.

What does the low concentration AFP tumor marker show:

• Down syndrome;
• intrauterine fetal death;
• trisomy 13, 18;
• maternal obesity.

Deviation from the norm does not always indicate pathological processes in the body. Even triple screening does not always guarantee a 100% result. Therefore, it is recommended to undergo a repeated examination, which will be prescribed by the attending physician. Only after a complete diagnosis can treatment be prescribed.