Chemical Pathology


  • As with most tumour markers there is a high incidence of false positive and false negative results; AFP is most appropriately used in monitoring disease progression or effectiveness of treatment once diagnosis of the tumour has been made AND serum concentrations of these markers have been shown to be raised prior to treatment.

AFP is a possible marker of:-

  • Non-Seminomatous Germ Cell Tumours (NSGCT) of testis, ovary and other sites (raised in 40-60% of cases but rarely in stage 1 disease)
  • Hepatocellular Carcinoma (HCC) ( raised in 70-90% of cases)
  • Hepatoblastoma (very rare in adults)
  • Use AFP in combination with beta-HCG to monitor NSGCT
  • Do not use for metastases to liver

Sample requirements

If patient on high dose biotin therapy (>5mg/day) collect sample at least 8 hours after the last dose

For adults, blood taken into a 5mL gold top tube (or rust top for the Acute Unit)

5ml gold tube

For children, blood taken into a 3.5mL rust top tube

3.5ml rust top tube

For neonates, blood taken into a 0.8 mL minicollect lithium heparin tube

Sample tube: pale green cap


Send at ambient temperature to the laboratory. If unavoidable, samples can be stored refrigerated overnight

Required information

Relevant clinical details including known or possible diagnoses (e.g. baseline level prior to treatment or follow up).

Turnaround times

The assays are run throughout the day Monday to Friday. The in-lab turnaround time is less than 1 week.

Reference ranges

Alpha-foetoprotein assayed using the Cobas AFP ECLIA.

Reference range: less than 6 kU/L

AFP may be raised in the following non-malignant conditions:-

  • Hepatitis
  • Cirrhosis
  • Biliary tree obstruction
  • Alcoholic liver disease
  • Ataxia telangiectasia
  • Hereditary tyrosinemia

AFP may be raised in the following physiological conditions

  • Pregnancy
  • 1st year of life ( falls to within adult levels between 6-12 months)

The ½ life in blood is 5 days

Further information

Lab Tests Online

BMJ 2009; 339: b3527 Serum tumour markers: how to order and interpret them

Page last updated: 20/04/2021