Alpha-Fetoprotein (AFP) Levels in Normal Children

Ohama, Kazunori; Nagase, Hayato; Oginö, Kazuhíde; Tsuchida, Kenji; Tanaka, Michio; Kubo, Mitsuhiko; Horita, Shigeru; Kawakami, Kazumori; Ohmori, Masayasu

doi:10.1055/s-2008-1071168

Cited by 49 publications

(27 citation statements)

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“…8 and No.17) might be physiologic, since the AFP level do not reach the adult level until 8 months of age (normal: less than 30 ng/mL at 1 yr of age, less than 15 ng/mL in adult) (10, 11). …”

Section: Resultsmentioning

confidence: 99%

Mesenchymal Hamartomas of the Liver: Comparison of Clinicopathologic Features between Cystic and Solid Forms

et al. 2006

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Mesenchymal hamartoma (MH) of the liver is an uncommon benign lesion related to ductal plate malformation. It is usually cystic and mainly composed of myxoid mesenchymal tissue with tortuous or cystic bile ducts. In order to characterize the clinicopathological features of MH, the Korean Gastrointestinal Pathology Study Group collected a total of 17 MH cases diagnosed in 7 hospitals from 1992 to 2002 and compared the clinicopathologic findings of cystic MH with those of solid variant. Among the 17 cases, 7 (41%) were solid. The solid form showed a higher serum level of α-fetoprotein (AFP), the smaller bile ducts, and more frequent proliferation of vessels. Serum AFP level was related to the amount of hepatocytes. Two of seven solid cases harbored a larger amount of evenly distributed hepatocytes and proliferation of small duct with focal hepatocyte-bile duct transition. These histologic findings are similar to those of mixed hamartoma. Therefore, the mixed hamartoma and the MH of both solid and cystic types could be the variants of one disease spectrum. And hepatocytes within MH might be rather a genuine tumor component than entrapped into the tumor. In conclusion, MH can show various clinicopathological features and recognition of these features will facilitate accurate diagnosis of MH.

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Section: Resultsmentioning

confidence: 99%

Mesenchymal Hamartomas of the Liver: Comparison of Clinicopathologic Features between Cystic and Solid Forms

et al. 2006

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“…15 AFP is an oncofetal glycoprotein and raised serum levels are an important marker for hepatoblastoma and yolk sac tumor. 16 Serum AFP is often raised in children with hepatoblastoma 9,17 and can be used as a tumor marker 18,19 or for disease staging. 20 Although serum AFP levels are elevated in 96% of children with hepatoblastoma and hepatocellular carcinoma, 9 raised serum AFP is reported in other childhood neoplasms, including Wilms' tumor 21 and pleuropulmonary blastoma.…”

Section: Discussionmentioning

confidence: 99%

Variable Antigen Expression in Hepatoblastomas

Ramsay

Bates

Williams

et al. 2008

Applied Immunohistochemistry &Amp; Molecular Morphology

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Hepatoblastoma is a malignant tumor that typically presents as a mass in the liver of a child less than 5 years of age. The diagnosis is usually established by means of a needle core biopsy before the treatment is commenced. The pathologic diagnosis of hepatoblastoma relies on the microscopic identification of typical morphologic features, but these may not be present in a needle core biopsy, and in this setting immunohistochemical staining has an important role in the exclusion of other childhood malignancies. We have studied 12 needle core biopsies from cases of hepatoblastoma, all of which had the diagnosis confirmed by subsequent resection of the tumor, to determine if these tumors show a diagnostic phenotype. The needle biopsies were immunostained with a standard panel of antibodies normally used in the characterization of childhood small round blue cell tumors, with the addition of antibodies directed against alpha-fetoprotein and alpha-1-antitrypsin. Our results indicate that the majority of hepatoblastomas expressed cytokeratins (10/12) and that alpha-1-antitrypsin and alpha-fetoprotein staining were positive in approximately half the cases (5/12 and 7/12, respectively). We also observed frequent expression of antigens normally expressed on other childhood tumors. A significant number of hepatoblastomas (8/12) expressed MIC-2 (CD99) an antigen normally associated with primitive neuroectodermal tumor, 4 cases showed positive staining with the neural-associated antigen NCAM (CD56), and 3 were positive with the neuroblastoma marker NB84. Occasional cases showed expression of the muscle marker desmin (2/12) and 2 cases stained with BCL2. Vimentin expression was seen in 1 case, and a single case also expressed the neural markers PGP9.5 and neurone-specific enolase. In all cases, the tumor cells were negative with CD45, WT1, and S-100. These findings indicate that the primitive cells in hepatoblastoma have a variable immunophenotype and can express antigens normally seen in other childhood malignancies. In the clinical setting of the differential diagnosis of childhood abdominal mass, hepatoblastoma shows no distinct immunohistochemical profile, and the diagnosis requires a combination of the clinical, imaging, and pathologic findings.

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“…With regard to the false positive AFP level mentioned by Dr. Graham, I am unfamiliar with the case but the risk of hepatoblastoma in infancy cannot be ascertained with a single value, since an infant without hepatoblastoma can be born with an AFP level that cannot be distinguished from an infant with hepatoblastoma [12]. Instead, the risk of hepatoblastoma should be related to the change in AFP levels.…”

Section: H Penney Gaul MD Frcpc (Pediatric Radiologist)mentioning

confidence: 99%