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Test ID AFPSF Alpha-Fetoprotein (AFP), Spinal Fluid

Reporting Name

Alpha-Fetoprotein, CSF

Useful For

An adjunct in the diagnosis of central nervous system (CNS) germinomas and meningeal carcinomatosis


Evaluating germ-cell tumors, including testicular cancer metastatic to the CNS in conjunction with beta-human chorionic gonadotropin measurement(1)


An adjunct in distinguishing between suprasellar dysgerminomas and craniopharyngiomas


A supplement to cerebrospinal fluid cytologic analysis

Specimen Type


Specimen Required

Container/Tube: Sterile vial

Specimen Volume: 1 mL

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
CSF Frozen (preferred) 7 days
  Refrigerated  7 days

Reference Values

<1.5 ng/mL

Values for alpha-fetoprotein in cerebrospinal fluid have not been formally established for newborns and infants. The available literature indicates that by 2 months of age, levels comparable to adults should be reached.(Ann Clin Biochem 2005;42:24-29)

Day(s) and Time(s) Performed

Monday through Friday; 5 a.m.-12 a.m., Saturday; 6 a.m.-6 p.m.

Test Classification

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information


LOINC Code Information

Test ID Test Order Name Order LOINC Value
AFPSF Alpha-Fetoprotein, CSF 1833-3


Result ID Test Result Name Result LOINC Value
AFSF Alpha-Fetoprotein, CSF 1833-3

Clinical Information

Alpha-fetoprotein (AFP) is an oncofetal glycoprotein, homologous with albumin that is produced both in early fetal life and in tumors arising from midline embryonic structures. AFP is synthesized in the yolk sac, liver, and gastrointestinal track of the fetus. In adults, the liver synthesizes AFP. AFP is not normally expressed in the central nervous system (CNS). AFP levels in liver are increased in hepatomas and hepatocellular and colon carcinomas, as well as in germ-cell tumors arising from the ovaries and nonseminomatous germ-cell tumors of the testes, testicular teratocarcinomas, and primary germ-cell tumors arising within the CNS. The presence of germinomas in the CNS and CNS involvement in metastatic cancer and meningeal carcinomatosis results in increased levels of AFP in cerebrospinal fluid.


Alpha-fetoprotein (AFP) concentrations that exceed the upper end of normal are consistent with the presence of central nervous system germinoma, meningeal carcinomatosis, or metastatic nonseminomatous testicular cancer. AFP is not elevated in the presence of a craniopharyngioma.

Clinical Reference

1. Jubran RF, Finlay J: Central nervous system germ cell tumors: controversies in diagnosis and treatment. Oncology 2005;19:705-711

2. Seregni E, Massimino M, Nerini Molteni S, et al: Serum and cerebrospinal fluid human chorionic gonadotropin (hCG) and alpha-fetoprotein (AFP) in intracranial germ cell tumors. Int J Biol Markers 2002;17(2):112-118

3. Coakley J, Kellie SJ: Interpretation of alpha-fetoprotein concentrations in cerebrospinal fluid of infants. Ann Clin Biochem 2005;42:24-29

Analytic Time

Same day/1 day

Method Name

Immunoenzymatic Assay