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Clinical significance of serum alpha‐fetoprotein subfractionation in pediatric diseases

Serum alpha‐fetoprotein (AFP) subfraction profile is a predictive indicator for the discrimination of hepatic malignancies, benign liver diseases and yolk sac tumor in adults. In the present study, AFP subfractions were examined in AFP‐positive sera from 59 patients of less than 15 years of age. Fractionation of AFP was carried out by lectin affinity crossed‐line immunoelectrophoresis. Concanavalin A, Lens culinaris hemagglutinin and phytohemagglutinin E were used as lectins. Fifty‐four of 59 (91.5%) AFP subfraction profiles in patients with pediatric diseases were classified into three common types: (1) benign liver disorder, (2) hepatic malignancy and (3) yolk sac tumor. An atypical AFP subfraction profile resembling hepatic malignancy type was found in 5 of 59 (8.5%) infants. It was concluded that estimation of serum AFP subfraction profiles facilitates differential diagnosis of various AFP‐positive pediatric diseases, such as hepatoblastoma. hepatoma, hepatic cirrhosis, hepatitis or germ cell tumors.