AFP - raised levels are seen most frequently in germ cell tumours and hepatocellular carcinoma, but also in gastric, colon, biliary, pancreatic and lung cancers (~20% of patients)
elevated serum AFP levels indicate the presence of yolk sac elements, i.e. mixed germ cell tumours (especially embryonal carcinoma and yolk sac tumours), and occur in all stages of disease [sensitivity 50-80% in metastatic disease, 70-72% in undifferentiated malignant teratoma, 60-64% in intermediate malignant teratoma, and 64% of patients with yolk sac or combination tumours]. AFP concentrations >1000 (850 kU/L) m g/L are found in 53% of undifferentiated malignant teratomas, 16% of intermediate malignant teratomas, and 26% of combination tumours (1)
elevated serum AFP levels may provide stronger evidence than histology in distinguishing pure seminomas and tumours with trophoblastic elements
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