[Clinical relevance of serum alpha-1-fetoprotein determinations]

History, physiological and pathological properties and clinical significance of alpha-1-fetoprotein (AFP) are reviewed in detail. Present observations suggest that additional information can be expected from AFP-determination as an index for prognosis and response to chemotherapy in patients with AFP-producing tumors. Prenatal diagnosis of fetal distress-syndrome, screening for primary carcinoma of the liver (PLC) and malignant germ cell-tumors containing yolk sac-tissue, and postoperative controls of therapeutic efficiency are mentioned as main indications for an AFP-test. Especially encouraging are the results of a 4-year prospective study, in which 108 patients with PLC have been found among 4000 patients with hepatobiliar diseases. Diagnostic efficiency of AFP, 67-gallium-scanning and celiacography is demonstrated in 80 patients with autopically verified PLC. Overall diagnostic value with a combination of AFP and 67-Gacitrate was 93.8%. Further studies have been carried out, analyzing the histological findings in 8 patients with and 8 patients without AFP-producing hepatocellular carcinomas. A comparison of diagnostic efficiency of three AFP-test-methods with different sensitivity-limits has been done.