Role of Alpha-Fetoprotein (AFP) in Diagnosing Childhood Cancers and Genetic-Related Chronic Diseases
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Published on: June 8, 2019
Joanna Głowska-Ciemny1,2, Marcin Szymanski1, Agata Kuszerska1,3
1PreMediCare Prenatal Research Center, ul. Czarna Rola 21, 61-625 Poznań, Poland.
Insights
High alpha-fetoprotein (AFP) levels in infants can obscure diagnoses. Establishing updated pediatric reference ranges for AFP is crucial for accurate diagnosis and monitoring in children.
Area of Science:
- Biochemistry
- Pediatric Medicine
- Clinical Diagnostics
Background:
- Alpha-fetoprotein (AFP) is vital during fetal development but persists postnatally.
- Elevated neonatal AFP can mask serious conditions in neurology, metabolism, hematology, endocrinology, and oncology.
- Current AFP reference values and diagnostic utility are established for adults, not children, leading to pitfalls.
Purpose of the Study:
- To highlight the diagnostic challenges posed by physiologically high AFP levels in infants.
- To emphasize the need for updated, age-specific reference ranges for AFP in pediatric populations.
- To propose a population-based study for establishing reliable pediatric AFP reference values.
Main Methods:
- Review of existing literature on AFP in pediatric diagnostics.
- Analysis of diagnostic pitfalls associated with elevated AFP in children.
- Proposal for a population-based study to determine new reference ranges.
Main Results:
- Physiologically elevated AFP in infants complicates the diagnosis of various pediatric diseases.
- Inconsistent laboratory data and limited pediatric oncology studies contribute to diagnostic uncertainty.
- There is a critical need for updated, statistically representative AFP reference ranges for children.
Conclusions:
- Current AFP assessment in children is hampered by high physiological levels and lack of specific reference data.
- Establishing updated pediatric AFP reference ranges is essential for accurate diagnosis, treatment monitoring, and surveillance.
- A population-based study is recommended to create reliable AFP reference values for the pediatric age group.
Abstract:
Alpha-fetoprotein (AFP) is a protein commonly found during fetal development, but its role extends beyond birth. Throughout the first year of life, AFP levels can remain high, which can potentially mask various conditions from the neurological, metabolic, hematological, endocrine, and early childhood cancer groups. Although AFP reference values and clinical utility have been established in adults, evaluating AFP levels in children during the diagnostic process, treatment, and post-treatment surveillance is still associated with numerous diagnostic pitfalls. These challenges arise from the presence of physiologically elevated AFP levels, inconsistent data obtained from different laboratory tests, and the limited population of children with oncologic diseases that have been studied. To address these issues, it is essential to establish updated reference ranges for AFP in this specific age group. A population-based study involving a statistically representative group of patients could serve as a valuable solution for this purpose.
