In normal fetuses, AFP binds the hormone estradiol. AFP is measured , in pregnant women using maternal blood or amniotic fluid, as a screening test for a subset of developmental abnormalities:
It is principally increased in open neural tube defects and omphalocoele & decreased in Down syndrome.

It is also measured in non-pregnant women, other adults, and children, serving as a biomarker to detect a subset of tumors.

In adults, levels over 500 nanograms/milliliter of AFP are seen in only three situations: Hepatocellular carcinoma, Germ cell tumors, and metastatic cancer in the liver originating from other primary tumors elsewhere.

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