AFP is raised in?

Appeared in: Chitranjjan National Cancer Institute Kolkata - 2021

Explanation

Alpha-fetoprotein (AFP) is an oncofetal antigen primarily used as a tumor marker.
Its levels are significantly elevated in adults with Hepatocellular Carcinoma (HCC), a type of liver cancer.
AFP is also a marker for non-seminomatous germ cell tumors (e.g., yolk sac tumors).
A serum AFP level above 300-1000 ng/L in a non-pregnant adult is highly suggestive of HCC.

Option A: The primary tumor marker for prostate cancer is Prostate-Specific Antigen (PSA), not AFP.
Option C: While Carcinoembryonic Antigen (CEA) can be elevated in lung cancer, AFP is not a standard marker for this malignancy. Specific markers for lung cancer include Neuron-Specific Enolase (NSE) for small cell lung cancer.
Option D: The most widely used tumor marker for colorectal cancer is Carcinoembryonic Antigen (CEA).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Tumor markers in oncology, specifically Alpha-fetoprotein (AFP) as background academic context rather than a clinical decision trigger.
Nurses play a vital role in patient education regarding lab tests like AFP, explaining their purpose for monitoring disease rather than for initial diagnosis.
Monitoring trends in tumor marker levels is a key nursing responsibility. A rising AFP level after treatment may indicate disease recurrence, requiring prompt reporting to the physician.
What if? - If a patient with chronic Hepatitis B or C and liver cirrhosis shows a progressively rising AFP level, the nurse should recognize this as a high-risk sign for the development of HCC and ensure the patient has follow-up imaging scheduled.

How to Approach the Question

First, identify the keyword in the question, which is 'AFP' (Alpha-fetoprotein).
Recall the primary associations of this specific tumor marker. AFP is strongly linked to liver cancer and certain germ cell tumors.
Evaluate the given options based on this knowledge.
Option B, 'HCC' (Hepatocellular Carcinoma), is a direct and strong association with elevated AFP.
Eliminate the other options by recalling their respective primary tumor markers: Ca prostate (PSA), Ca Colon (CEA), and Ca lung (CEA, NSE, etc.).
Confirm that HCC is the best fit among the choices.

Concept Tested & Keywords

Concept Tested: Tumor markers in oncology, specifically Alpha-fetoprotein (AFP).
Stem keywords: AFP, raised in
Lead-in keywords: is

QgIAsY0tU2DqYY50464cAd

E6 Textbook of Biochemistry for medical StudentsDM Vasudevan Part 2 — Subpart B (pp 240-463 of 478) p. 113-115

E6 Harper's Illustrated Biochemistry2023 (pp 26-793 of 813) p. 693-695

Practise the full Chitranjjan National Cancer Institute Kolkata - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.