Professional and Linguistic Assessments Board (PLAB) Practice Exam

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What does A-fetoprotein indicate in a clinical setting?

Breast cancer
Hepatocellular carcinoma
Lung cancer
Pancreatic cancer

The correct answer is: Hepatocellular carcinoma

A-fetoprotein (AFP) is a protein that is normally produced by the liver and yolk sac of a developing fetus. In a clinical setting, elevated levels of AFP are primarily associated with hepatocellular carcinoma, which is the most common type of liver cancer. The measurement of AFP can therefore serve as a tumor marker, aiding in the diagnosis and monitoring of therapeutic responses in patients with liver tumors. In addition to liver cancer, elevated AFP can also occur in certain conditions, such as germ cell tumors and liver diseases like hepatitis or cirrhosis, but its most significant role in malignancy is related to hepatocellular carcinoma. This specificity makes AFP a valuable tool for clinicians when assessing patients with suspected liver pathology or malignancy. The other cancer types listed—breast cancer, lung cancer, and pancreatic cancer—do not typically show a correlation with elevated AFP levels, which is why those options do not represent the proper clinical context for this biomarker.