Nowadays, health checkups are becoming more and more popular, so there are often patients who come to the clinic with a medical report saying that their AFP is elevated and they are so scared that they can’t eat or sleep for a few days. AFP is one of the tumor markers, it is a glycoprotein, mainly synthesized in fetal liver, and the amount of AFP in normal human serum is less than 20μg/L. AFP is the best serum marker to diagnose early liver cancer, and it is elevated in about 80% of primary liver cancer patients. It is also elevated 6-12 months before the onset of symptoms. It can be used as a basis for screening and diagnosis of liver cancer, evaluation of efficacy and reflecting changes in the disease. However, not all elevated AFP is caused by liver cancer, but it is also common in the following cases: 1. Other malignant tumors In addition to primary liver cancer, about 50% of patients with germline embryonal tumors also have elevated AFP, and a few others such as stomach, intestine or lung cancer may also have elevated AFP. 2. Non-malignant diseases (1) Viral hepatitis In adults with viral hepatitis, especially those with chronic hepatitis in its active stage, AFP may also be elevated, but it usually decreases or returns to normal after treatment. (2) Cirrhosis AFP is also elevated in a small number of patients with cirrhosis, and the synthesis of AFP reflects the degree of liver cell damage and disease activity: its elevation is mainly due to the regeneration and infantilization of damaged hepatocytes, the hepatocytes will regain the ability to produce AFP, and with the repair of damaged hepatocytes, AFP gradually returns to normal. (3) Neonatal hepatitis 30% of neonatal hepatitis can be measured AFP, the incidence increases with the severity of the disease, and most of them are significantly higher. (4) Others Such as liver injury, congestive hepatomegaly, ataxia, congenital bile duct occlusion, malformed fetus, etc. can also appear elevated AFP, but generally the increase is small and does not last long. 3, pregnant women Generally after 3 months of pregnancy may appear AFP (AFP) significantly elevated, to July-August pregnant women in maternal blood AFP amount reached the highest peak and relatively stable. About 3 weeks after delivery, AFP will slowly decline and return to normal. 4. Newborns Newborns also experience a transient elevation of AFP because AFP is a normal plasma protein component of the fetus and is the main protein in the early embryonic period, which disappears from the blood about two weeks after birth. This shows that elevated AFP is not necessarily liver cancer. The little girl’s further test results also confirmed that she was not suffering from liver cancer, and she went home with a happy heart. There is no need to be anxious because of a mildly elevated AFP in one test. However, we should not leave it alone, we need to cooperate with some other tests to confirm whether we have liver cancer or not. Therefore, HBV and HCV marker tests must be performed when liver cancer is suspected. The commonly used tests are hepatitis B five items, HBV DNA and HCV RNA. The most commonly used imaging tests are ultrasound, and CT and MRI can be performed if there are abnormalities or the diagnosis is unknown. If AFP is not high, does it mean that liver cancer is completely excluded? This answer is also negative. About 20% of liver cancer patients have normal serum AFP test and need to combine with the above tests to confirm whether they have liver cancer. Thus, AFP is a serum marker for the diagnosis of early stage liver cancer. However, the diagnosis of hepatocellular carcinoma needs to be combined with the results of several tests, and a single initial screening test of elevated AFP is not equivalent to hepatocellular carcinoma. Therefore, when we encounter such a situation, we should not immediately judge ourselves as having liver cancer, but at the same time, we should have a certain sense of worry and actively cooperate with doctors for various examinations, so as to be responsible for our own health.