Alpha fetoprotein (AFP)

Topic Completed: 1 December 2011

Revised: 2 April 2020

Copyright: 2003-2019,, Inc.

PubMed Search: alpha fetoprotein

Nat Pernick, M.D.
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Cite this page: Pernick N. Alpha fetoprotein (AFP). website. Accessed April 6th, 2020.
Definition / general
Uses by pathologists
  • Serum marker:
    • Elevated in maternal serum or amniotic fluid ( > 2.5 multiples of median at a specified gestational age) if fetal developmental anomalies
    • Serum tumor marker elevated in patients with hepatoblastoma (eMedicine), hepatocellular carcinoma, hepatoid adenocarcinoma, testicular cancer (other than pure seminoma) and yolk sac tumor, but not in intrahepatic cholangiocarcinoma (Am Surg 2010;76:1210)
    • Preoperative levels are prognostic for hepatocellular carcinoma (World J Surg Oncol 2013;11:212)

  • Immunostain:
    • Somewhat sensitive and specific for hepatocellular carcinoma, hepatoid adenocarcinoma, germ cell tumors and particularly yolk sac tumor
Microscopic (histologic) images

Images hosted on Pathout server:

Dysgerminoma - ovary (negative staining)

Liver: HCC

Images hosted on other servers:

Hepatoid adenocarcinoma: gallbladder, lung, ovary, skull base, stomach

Liver: adult hepatic blastoma (fig B)

Yolk sac tumors: urachus, testis

Yolk sac tumor arising in mature teratoma of liver

Positive staining - normal
  • Early fetal gut, hepatocytes and yolk sac
Positive staining - disease
Negative staining
  • Hepatocellular carcinoma-diffuse cirrhosis-like variant (Am J Surg Pathol 2010;34:935)
  • Cholangiocarcinoma, hepatocellular adenoma and seminoma
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