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PTD - 153

Test Directory -  Alpha-fetoprotein (tumour marker)

Please note that for monitoring purposes results from Basildon and Southend are comparable, but results from other laboratories may differ due to methodological differences



Clinical Indications

AFP tumour production mainly confined to 3 malignancies: Non-seminomatous germ cell tumours (NSGCT) of testis, ovary and other sites, hepatocellular carcinoma and hepatoblastoma (in children, extremely rare in adults). In addition, AFP may be occasionally elevated in patients with various adenocarcinomas.

Request Form 

Combined Pathology Blood form (Yellow/Black or Blue for GP's)


On request if specific criteria met or requested by Consultant Gastroenterologist.

Specific Criteria

In cirrhosis or chronic hepatitis to rule out hepatocellular carcinoma. Known or clinically suspected hepatocellular or testicular carcinoma. AFP should not be used to screen for liver metastasis.

Patient Preparation


Samples should not be taken from patients receiving therapy with high
biotin doses (i.e. > 5 mg/day) until at least 8 hours following the last biotin

Turnaround Time

Same day (Monday to Friday)




1 ml


Yellow top (SST) tube or

paediatric orange top (lithium-heparin)

Causes for Rejection

Unlabelled sample. Not meeting specific criteria for analysis. 

Reference Range

< 7.0 U/mL

Reference: Roche method insert

Half-life in Serum

Approx. 5 days.


AFP elevated in 70-90% of patients with hepatocellular cancers with levels between 1,000 and 100,000, and 40-60% of patients with germ cell tumours of the testis. Benign conditions associated with elevated AFP include hepatitis, cirrhosis, biliary tract obstruction, alcoholic liver disease and ataxia telangiectasia.

Rate of change of AFP level is important, an increasing rate suggests malignancy in the liver.

AFP levels in term babies may be up to 100,000. Levels decline to adult reference range at 6 months. (ref: ARUP laboratories).

Lab. Handling

Processing:  AFPT and analysed from primary tube and stored at 4C in the cold room. (NOAFP and save in separating freezer (CB40) at -20C, saved frozen rack)

Version 1.4 / January 2015                                                                                                     Approved by: Consultant Biochemist