Alpha-Fetoprotein in Malignant Pediatric Conditions

Abstract

Abnormal serum α-fetoprotein (AFP) levels are frequently observed in common disorders such as spina bifida or Down's syndrome in the fetus and cancer in children and adults. The focus of this chapter summarizes on the role of serum α-fetoprotein (AFP) as a useful biomarker in malignant pediatric tumors. The fetal yolk sac and liver generate high levels of AFP during gestation and decline over the next 12 months of infancy, and only trace amounts are detected in childhood. As a result, persistent elevation of AFP correlates with a number of select pediatric malignant conditions. Serum AFP is overexpressed in a considerable fraction of germ cell tumors (GCTs), hepatoblastoma (HB), and hepatocellular carcinoma (HCC). We provide the reader with a review of AFP as a useful specific marker for the diagnosis, management, and followup in select pediatric cancers.

The Curious Case of the HepG2 Cell Line: 40 Years of Expertise

“…An increase in the AFP level promotes the proliferation of tumor cells and the formation of blood vessels and enhances the antiapoptotic effect of cancer cells [ 74 ]. Changes in the AFP level also predict the course of disease, the therapeutic response, and the occurrence of relapse [ 75 ].…”

A quantitative universal NGS-based ctDNA assay for hepatoblastoma

“…Serum AFP concentrations are highly elevated in neonates and exceedingly high levels can be observed in premature infants due to their developmental stage 28 , making AFP an inaccurate measurement in this population. Incidence rate for hepatoblastoma have been increasing in developed countries worldwide in the last decades by about 2.5% per year 29 , and is attributed in part to the increased survival rates of premature babies, as extremely premature babies with a birth weight of less than 1 kg have been reported to have a greatly increased risk of developing hepatoblastoma 30 .…”

Hepatic mesenchymal hamartoma: An uncommon but important paediatric diagnosis

“…Alfa fetoprotein levels should thus be correlated with imaging and histopathology findings whilst taking the patient’s age into account. 8 , 9 , 10 …”

“…Alfa fetoprotein levels should thus be correlated with imaging and histopathology findings whilst taking the patient's age into account. 8,9,10 Mesenchymal hamartomas are commonly large at the time of diagnosis, weighing over 1 kg, and most commonly arise from the right lobe of the liver. These lesions arise from the mesoderm within portal tracts.…”