Beyond conventional biomarkers: the role of alpha-fetoprotein in gastroenteropancreatic neuroendocrine neoplasms
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By
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March 19, 2026
Objective:
To evaluate the role of alpha-fetoprotein (AFP) as a biomarker in gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs), particularly in comparison to its established roles in other cancers.
Key Findings:
- AFP elevation is rare in GEP-NENs but associated with advanced disease, high tumor grade, and increased proliferative activity across ten studies.
- Elevated AFP levels correlate with poorer survival outcomes and higher treatment response rates in chemotherapy.
- The prognostic value of AFP diminishes after adjusting for clinicopathological factors.
Interpretation:
AFP may identify biologically aggressive subsets of GEP-NENs and reflect disease burden, but it should not be considered an independent biomarker; its implications for clinical practice warrant further exploration.
Limitations:
- AFP's prognostic value is not independent of other clinicopathological factors.
- Heterogeneity in study design and AFP cut-off values complicates interpretation, highlighting the need for further research.
Conclusion:
AFP holds potential as a contextual signal of aggressive tumor biology and as an adjunctive tool within integrated clinical frameworks, suggesting avenues for future research.
