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HelpTest Code AFP-NM Alpha-Fetoprotein (AFP) Tumor Marker, Serum
Additional Codes
| Mayo Test ID |
|---|
| AFP |
Reporting Name
Alpha-Fetoprotein, Tumor Marker, SUseful For
Follow-up management of patients undergoing cancer therapy, especially for testicular and ovarian tumors and for hepatocellular carcinoma
Often used in conjunction with human chorionic gonadotropin.(2)
This test is not recommended as a screening procedure for cancer detection in the general population.
This test is not intended for the detection of neural tube defects.
This test is not useful for patients with pure seminoma or dysgerminoma.
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumOrdering Guidance
This test is used as a tumor marker and is not intended for the detection of neural tube defects. For testing amniotic fluid specimens, order AFPA / Alpha-Fetoprotein, Amniotic Fluid.
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.6 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 7 days | |
| Frozen | 90 days |
Special Instructions
Reference Values
<8.4 ng/mL
Reference values are for nonpregnant subjects only; fetal production of alpha-fetoprotein elevates values in pregnant women.
Range for newborns is not available, but concentrations over 100,000 ng/mL have been reported in normal newborns, and the values rapidly decline in the first 6 months of life.(See literature reference: Ped Res 1981;15:50-52) For further interpretive information, see Alpha-Fetoprotein (AFP)
Serum markers are not specific for malignancy, and values may vary by method.
Day(s) Performed
Monday through Friday
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
82105
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| AFP | Alpha-Fetoprotein, Tumor Marker, S | 53962-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| AFP | Alpha-Fetoprotein, Tumor Marker, S | 53962-7 |
Clinical Information
Alpha-fetoprotein (AFP) is a glycoprotein that is produced in early fetal life by the liver and by a variety of tumors including hepatocellular carcinoma, hepatoblastoma, and nonseminomatous germ cell tumors of the ovary and testis (eg, yolk sac and embryonal carcinoma). Most studies report elevated AFP concentrations in approximately 70% of patients with hepatocellular carcinoma. Elevated AFP concentrations are found in 50% to 70% of patients with nonseminomatous testicular tumors.(1)
AFP is elevated during pregnancy. Persistence of AFP in the mother following birth is a rare hereditary condition.(2) Neonates have markedly elevated AFP levels (>100,000 ng/mL) that rapidly fall to below 100 ng/mL by 150 days and gradually return to normal over their first year.(2)
Concentrations of AFP above the reference range also have been found in the serum of patients with benign liver disease (eg, viral hepatitis, cirrhosis), gastrointestinal tract tumors, and along with carcinoembryonic antigen, in ataxia telangiectasia.
The biological half-life of AFP is approximately 5 days.
Interpretation
Alpha-fetoprotein (AFP) levels may be elevated in association with a variety of malignancies or benign diseases.
Failure of the AFP value to return to normal by approximately one month after surgery suggests the presence of residual tumor.
Elevation of AFP after remission suggests tumor recurrence; however, tumors originally producing AFP may recur without an increase in AFP.
Cautions
This assay is intended only as an adjunct in the diagnosis and monitoring of alpha-fetoprotein (AFP)-producing tumors. The diagnosis should be confirmed by other tests or procedures.
Higher values are found in newborns and pregnant women.
In some immunoassays, the presence of unusually high concentrations of analyte may result in a high-dose "hook" effect. This may result in a lower or even normal measured analyte concentration. If the reported result is inconsistent with the clinical presentation, the laboratory should be alerted for troubleshooting. For diagnostic purposes, these immunoassay results should always be assessed in conjunction with the patient’s medical history, clinical examination, and other findings. For the Beckman Access AFP assay a hook effect is not expected up to 500,000 ng/mL. Concentrations greater than 500,000 ng/mL might result in a falsely low result.
Report Available
1 to 3 daysReject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
Method Name
Immunoenzymatic Assay
Forms
If not ordering electronically, complete, print, and send Oncology Test Request (T729) with the specimen.