Slightly elevated AFP

Hello,

I'm a 54 yr. old female, two grown children, never smoked, slightly overweight. I have taken zocor for about 4 years, and have regular blood tests. 6 months ago I had slightly elevated LFTs for the first time. The cardiologist ordered more bloodwork and a very thorough liver and abdominal ultrasound. Liver enzymes were down a little, and the ultrasound showed a slightly enlarged, fatty liver; no mention made of tumors or anything else.  He sent me to my gastroenterologist, who ordered extensive bloodwork. We are now awaiting pre-certification for a CT scan.

That bloodwork showed my LFTs back to normal, but my alpha fetoprotein at 7, 1 point higher than "normal" (up to 6, apparently, for that lab.) The doctor said that my Hepatitis panel indicated HBsAg negative, HBsAb positive, and HBcAb negative, indicating either a vaccination I have forgotten, or a "cleared" infection (I have NONE of the risk factors, though I was adopted and don't know my birth mother's hepatitis status.)

My gastroenterologist yesterday ordered one more blood test for AFP and "total" Hepatitis B, which apparently had not been done previously. She wants to rule out any cirrhosis, I think, though it's the thought of liver cancer that scares me.

I am frankly terrified by that slightly elevated AFP (though I have seen that values < 10 are "normal" in most instances.) I am scared silly at the thought of liver cancer, though somewhat heartened by the ultrasound, which showed just the "fatty" deposits.  Am I overreacting here? Thank you for your insight.

[Kevin Pho, MD]

The appropriate testing has been done.  With a negative ultrasound, the chances of liver cancer are less likely.  Further imaging, as you are doing with the CT scan, is recommended to confirm.  You can also consider an MRI for more definitive imaging.  

I agree with the blood tests, including screening for hepatitis.  

If the diagnosis continues to be in question, a liver biopsy can be considered and discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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