<P> In the context of evidence - based medicine, AFP is validated at the highest level as a tumor marker for use in patients with nonseminomatous germ cell tumors . </P> <P> There are case reports of elevated AFP associated with teratoma . However, some of these case reports involve infants but do not correct for the normal elevation of AFP in infants, while others ignore the likelihood that teratoma (and other germ cell tumors) may in fact be mixed tumors containing elements of endodermal sinus tumor . </P> <P> AFP is normally elevated in infants, and because teratoma is the single most common kind of tumor in infants, several studies have provided reference ranges for AFP in normal infants . Perhaps the most useful is this equation: log Y = 7.397 - 2.622. log (X + 10), where X = age in days and Y = AFP level in nanograms per milliliter . When neonatal AFP is above normal (after adjustment for age), a low fraction of AFP - L3 is reassuring . </P> <P> For hepatocellular carcinoma (HCC), AFP cannot be considered to be specifically diagnostic of HCC, levels of AFP may be elevated in serum from patients with chronic disease; for example, research has indicated that AFP is not useful for screening in patients suffering from cirrhosis or Hepatitis C and therefore elevated AFP in these patients may not be indicative, or be only suggestive, of HCC . AFP is considered a useful marker for post-treatment monitoring of HCC patients (e.g. for treatment efficacy or tumor recurrence). The value of such tests may be improved by parallel monitoring of other markers . </P>

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