Definition

AFP testing is done to check the level of AFP (alpha fetoprotein) in the blood. AFP is a type of protein that is produced by a developing fetus, and is only detected in small amounts in normal adults. In the fetus, this protein can be found in amniotic fluid and can also enter the pregnant mother's body through the placenta.

AFP examination can be done on pregnant women during the second trimester of pregnancy. Abnormal AFP levels in mothers can increase suspicion of neural disorders or genetic disorders in the fetus. In Indonesia itself, this examination is generally carried out as a tumor markerTumor markers are molecules in the blood that increase when a person has a certain cancer. AFP protein can be produced by several types of cancer such as liver cancer or testicular cancer.

Indication

• Aged 35 years and above.
• Taking harmful drugs during pregnancy.
• Having diabetes.

In patients who are not pregnant, AFP examination can be used as one of the supporting diagnoses and evaluations for medical conditions such as:

• Liver cancer
• Testicular cancer
• Cervical cancer
• Pancreatic cancer
• Lymphoma (cancer of the lymph system)
• Liver cirrhosis (formation of scar tissue in the liver organ that interferes with its function)

AFP examination is useful in establishing or eliminating the possibility of a cancer diagnosis in patients. In addition, this examination is also useful for evaluating chemotherapy treatment being taken by cancer patients, whether the patient responds well to treatment or not. This examination is also one of the examinations that can be used by doctors to evaluate the condition of liver cirrhosis and hepatitis sufferers.

Contraindications

There are no special diseases or conditions that are contraindications to AFP examination. Everyone can do AFP examination without exception.

Preparation Before the Examination

There is no special preparation before the examination. If you are pregnant, you can tell the doctor more about your current condition, how your previous pregnancy was, as well as your and your family's disease history.

Examination Procedure

AFP examination is done by taking a blood sample. Laboratory officers will clean the area of the body where the blood sample is taken with sterile alcohol swabs. Generally, officers take blood samples from the vessels in the arm folds. The blood is then taken using a sterile syringe and placed in a special tube.

Furthermore, blood samples will be taken to the laboratory for analysis with special equipment. The results of the examination will generally come out within 1 - 2 weeks. In pregnant women, a weight check will be done first before the blood collection procedure. 

AFP test results can vary depending on your gender, pregnancy, and current medical conditions. Normally, AFP levels are less than 10 ng/mL, or in the range of 10 - 20 ng/mL (nanograms per milliliter) in adults. An AFP level that is too high in the blood, more than 400 ng/mL can be a sign of a medical disorder.

Results and Suggestions (Follow-up Examination)

Increased

Elevated AFP levels can be caused by medical conditions such as cancer or liver disorders. AFP levels can also be checked to evaluate whether cancer patient treatment is successful or not. If AFP levels remain elevated even though the patient has received anticancer drug therapy, it means that cancer cells are still spreading and the therapy is considered unsuccessful.

If an increase in AFP levels is found in pregnant women, this can be a marker of abnormalities in your fetal neural tube (spina bifida) or on the brain and skull (anensefali). Usually the doctor will see your gestational age by AFP levels, whether it is increased significantly or still within normal limits in pregnant women.

However, it should be remembered that AFP is a screening test and not a diagnostic test for pregnant women. The results of the test on the mother only inform that the pregnant woman is at risk of having a fetus with a disorder. 

Decreases

In general, a decrease in AFP occurs when patients receive anticancer treatment, which indicates that the patient is responding well to the therapy given. If AFP levels do not return to normal within 1 month of cancer therapy, this indicates that the disease is stable, but has not shown any significant results.

If your AFP value is low during pregnancy, this may indicate abnormalities in your fetus such as Down syndrome or Edwards syndrome. Repeated pregnancies can also show AFP results that are less than the normal range. This result does not mean that there is a special abnormality in your fetus, but it is an indication that other examinations are needed to confirm the diagnosis.

Consult the Right Doctor

Pregnant women with abnormal AFP can consult a gynecologist about the condition of the fetus. The doctor may suggest you have further examinations such as an ultrasound or amniocentesis

You can also consult a specialist internal medicine doctor to find out the next steps related to your possible condition and the therapy that can be done.

Want to know information about the results of laboratory, radiology, and other examinations? Check it out here, yes!