Update on the applications and limitations of alpha-fetoprotein for hepatocellular carcinoma

Table 1 Causes of alpha-fetoprotein elevation[13-15]

Hepatic	Non-hepatic
Neoplastic	Neoplastic
Hepatocellular carcinoma	Germ cell tumors (testicular and ovarian malignancies)
Intrahepatic cholangiocarcinoma	Gastric cancer
Non-neoplastic	Non-neoplastic
Liver cirrhosis	Normal pregnancy/infancy
Fulminant acute hepatitis	Colitis
Acute and chronic viral hepatitis	Fetal disorders (Gastroschisis, Neural tube defect)
Chronic liver diseases	Ataxia telangiectasia
Biliary obstruction (Intrahepatic and extrahepatic causes)	Hereditary tyrosinemia type 1
Drug induced hepatitis	Hereditary AFP persistence
Alcohol liver disease	Beckwith-Wiedemann syndrome
Non-alcoholic liver disease	Systemic lupus erythematosus
Neonatal hepatitis	Hirschsprung’s disease
Massive hepatic necrosis
Wilson disease
Hemochromatosis

AFP: Alpha-fetoprotein.