Alpha-fetoprotein (AFP) is a protein produced by the liver. For non-pregnant men and women, normal AFP levels are typically below 4 ng/ml or 7,75 IU/ml. Elevated AFP levels are often observed with primary liver cancer, particularly hepatocellular carcinoma (HCC). Consequently, this test is widely used to assist in screening and monitoring liver cancer. However, an increased AFP level does not definitively confirm a liver cancer diagnosis.

A doctor consults with a patient. *Photo: Tam Anh General Hospital*

In practice, AFP serves as a supportive marker but lacks the specificity for a definitive diagnosis. Various factors can elevate AFP levels, including active hepatitis B or C virus, cirrhosis caused by alcohol, viral infections, or fatty liver disease, as well as acute and chronic liver damage. Additionally, pregnant women may experience a physiological increase in AFP, and some other types of cancer can also cause this elevation.

When elevated AFP levels are detected, doctors evaluate the degree of elevation, review the patient's medical history, and assess risk factors such as chronic hepatitis B, C, or cirrhosis. They also order further diagnostic tests to identify the underlying cause. Currently, two highly effective tests for liver cancer screening are: AFP-L3 and PIVKA-II.

Diagnosing liver cancer requires a comprehensive approach, combining physical examinations, blood tests, tumor markers, and imaging techniques such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). A definitive cancer diagnosis ultimately relies on histopathological biopsy results. If your AFP levels are high, it is important not to panic, but also not to be complacent. You should consult a doctor to understand your test results, assess the reason for the elevated AFP, and determine the appropriate course of treatment.

Associate Professor, Doctor Ngo Thi Tinh

Department of Oncology

Tam Anh General Hospital Hanoi