Doctors often monitor tumor markers in the blood to help diagnose and treat liver cancer. Alpha-fetoprotein (AFP) is the most common tumor marker that doctors monitor.
Liver cancer is one of the leading causes of death in the United States. A combination of genetics and environmental factors such as hepatitis infection and high alcohol consumption play a role in its development.
Tumor markers, also called biomarkers, are substances produced by cancer cells that can be detected in your blood. Doctors use tumor markers to:
- help diagnose liver cancer
- monitor how well your treatment is working
- estimate your outlook
Alpha-fetoprotein (AFP) is the most common tumor marker doctors evaluate, but many other tumor markers are under investigation.
Liver cancer fast facts
- The American Cancer Society estimates
41,210 peoplein the United States will receive a diagnosis of liver cancer in 2023.
- Liver cancer rates have
tripledsince the 1980s.
- Long-term alcohol abuse and chronic infectious hepatitis are the
leading risk factorsfor liver cancer.
- Asian Americans and Pacific Islanders have the highest rates of liver cancer in the United States.
- The most common type of liver cancer, hepatocellular carcinoma (HCC), is
much more commonin men than women. The fibrolamellar subtype occurs more in women.
- Although we typically avoid using “men” and “women” in favor of more inclusive terms, specificity is key when reporting on clinical findings, and the survey referenced didn’t report data on people who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.
AFP is the most common tumor marker doctors monitor for liver cancer. Researchers are still investigating the potential benefits of monitoring other tumor markers.
AFP is a molecule usually produced by the liver and yolk sac of unborn babies. Its main function is to help transfer molecules from the pregnant person to the fetus such as copper, fatty acids, and bilirubin.
AFP is normally found in small amounts in the blood of adults. High amounts of AFP suggest HCC, the most common type of liver cancer.
AFP levels can also be elevated in people who are pregnant and people with other liver diseases, such as:
- liver cirrhosis
- liver necrosis
- chronic hepatitis
Researchers have identified three variants of AFP called AFP-L1, AFP-L2, and AFP-L3.
AFP-L3 is specific to liver cancer. The ratio of AFP-L3 to total AFP can potentially help doctors differentiate liver cancer from other types of liver disease.
An AFP-L3 to total AFP ratio more than
Abnormal prothrombin (APT)
Abnormal prothrombin (APT) can be found in the blood of people with HCC or vitamin K deficiency. It’s been used as a tumor marker for diagnosing liver cancer in Japan, Europe, and the United States for many years.
APT goes by other names, such as:
- protein induced by vitamin K antagonist-II
- acarboxy prothrombin
GOLGI 73 (also known as GOLPH 2 or GP 73)
GP 73 isn’t a specific biomarker for liver cancer but might be a potentially useful biomarker for identifying cancer in general. Elevated levels have been noted in other cancers, such as:
Phosphatidylinositol proteoglycan (GPC3)
Heat shock protein
Research suggests the detection rate of HCC increases when OPN testing is combined with AFP and other biomarkers.
Tumor marker testing can potentially help doctors detect liver cancer before symptoms develop.
It’s generally accepted that people with AFP levels more than 400 nanograms per milliliter (ng/mL) can receive a diagnosis of liver cancer. But the use of AFP testing is still controversial since it provides high false-negative rates, meaning it suggests you don’t have liver cancer when you do.
Research suggests that using a cutoff value of 400 ng/mL for AFP correctly identifies people who don’t have liver cancer in 95–100% of cases but only correctly identifies liver cancer in 20–45% of cases.
Doctors can use tumor markers such as AFP to determine whether you’re responding to treatment. A
Some tumor markers can help doctors predict your outlook. For example, a concentration of AFP greater than
Doctors use tumor markers to help detect liver cancer, monitor your response to treatment, and predict your outlook. The most common tumor marker that doctors monitor is called AFP.
Researchers are continuing to examine the role of other tumor markers in monitoring liver cancer. Combining some other markers such as AFP-L3 with AFP may help improve the accuracy of diagnosis.