Increased alpha-fetoprotein

Introduction Alpha-fetoprotein is a glycoprotein, acronym AFP. Under normal circumstances, this protein is mainly derived from embryonic liver cells. After about two weeks of birth, alpha-fetoprotein disappears from the blood, so the alpha-fetoprotein content in normal human serum is less than 20 micrograms per liter. Alpha-fetoprotein (-fetoprotein, FP or AFP) is mainly synthesized in fetal liver with a molecular weight of 69,000. AFP accounts for 1/3 of total plasma protein in 13 weeks. It reached its peak at 30 weeks of gestation and gradually decreased afterwards. The plasma concentration at birth was about 1% of the peak period, about 40 mg/L, and it was close to the adult level (less than 30 mg/L) at the age of one year.

Cause

Fetal protein can be elevated in about 80% of liver cancer patients, and AFP positive rate in germ cell tumors is 50%. Patients with other gastrointestinal tumors such as pancreatic cancer or lung cancer and cirrhosis may also experience different degrees of elevation. It is also one of the main diagnostic steps for diagnosing liver tumors, and of course it must be determined by other relevant tests.

an examination

Related inspection

Magnetic resonance imaging (MRI) blood test

There are several methods for detecting alpha-fetoprotein measured by radioimmunoassay with alpha-fetoprotein greater than 500 g/L. The alpha-fetoprotein measured by radioimmunoassay is greater than 500 g/L for 4 weeks, or alpha-fetoprotein. At 200-500 g/L for 8 weeks, after removing other factors that cause alpha-fetoprotein increase, such as acute and chronic hepatitis, post-hepatitis cirrhosis, embryonal tumor, and digestive tract cancer, it is necessary to combine positioning and examination, such as B. Diagnosis can be made by ultra, CT, magnetic resonance (MRI) and hepatic angiography. However, alpha-fetoprotein is also elevated in normal pregnant women, a small number of hepatitis and cirrhosis, and gonad malignant tumors, but the increase is not as high as that of liver cancer. The serum alpha-fetoprotein concentration in patients with cirrhosis is between 25 and 200 micrograms per liter. It usually decreases with the improvement of the disease within 2 months, most of which will not exceed 2 months. At the same time, the transaminase is elevated, when the transaminase is decreased. The post-alpha-fetoprotein also decreased, and the serum alpha-fetoprotein concentration was often parallel to the transaminase. If the alpha-fetoprotein concentration is above 500 g/L, although there is an increase in transaminase, the possibility of liver cancer is high, the transaminase is decreased or stabilized, and the alpha-fetoprotein is elevated, and liver cancer should be highly suspected.

Differential diagnosis

Serum testosterone concentration is significantly increased: the normal menstrual cycle follicular phase, the average serum testosterone concentration is 0.43ng / ml, the high limit is 0.68ng / ml, such as more than 0.7ng / m1 (equal to 2.44nmol / L), known as high Testosteroneemia, or hyperandrogenism. Ovarian, adrenal cortex, etc. can synthesize cholesterol from acetic acid, or absorb cholesterol from the blood as a matrix, synthesize steroid hormones, and secrete into the blood circulation. The androgens in the blood circulation are mainly DHEAS, DHEA, androstenedione (4A), testosterone (T) and dihydrotestosterone (DHT). High testosteroneemia, which is formed by the high levels of these hormones, especially testosterone in the blood.

Serum immunoglobulin can be elevated: immunoglobulin, which refers to animal protein with antibody activity. It is mainly found in plasma and is also found in other body fluids, tissues and some secretions. Serum immunoglobulins (Ig) include: IgG, IgA, IgM, IgD, IgE. The normal range is IgG 7.6 to 16.6 g/L; IgA 0.71 to 3.35 g/L, IgM 0.48 to 2.12 g/L, IgD 0.01 to 0.04 g/L, and IgE 0.001 to 0.009 g/L. Common reasons are:

1, chronic liver disease: including autoimmune chronic hepatitis, chronic active hepatitis, cirrhosis, chronic alcoholic liver disease, primary biliary cirrhosis. The degree of globulin increase is related to the severity of liver disease.

2. Autoimmune diseases.

3, chronic inflammation and chronic infections: such as tuberculosis, malaria and so on.

4, M globulinemia: such as multiple myeloma, lymphoma, primary macroglobulinemia.

Increased serum calcitonin levels: Serum calcitonin is a hormone secreted by thyroid follicular cells. When it is elevated for some reason, it can increase the amount of calcium excreted by the kidneys and lower the blood calcium concentration. Calcitonin is a thirty-two peptide containing a disulfide bond and has a molecular weight of 3,400. Normal human serum has a calcitonin concentration of 10-20 ng/L and a plasma half-life of less than 1 h, which is mainly degraded and excreted in the kidney. The main role of calcitonin is to lower blood calcium and blood phosphorus. The main target organ is bone, which also has a certain effect on the kidney.

Elevated serum TG levels: Serum triglycerides (TG) are one of the components of blood esters. Triglycerides are in a dynamic equilibrium in the human body. The content of blood esters can vary with changes in the diet and varies widely. In addition, its content increases with age, especially in middle-aged and elderly people whose body weight exceeds the standard.

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