α-胎兒蛋白(英語:Alpha-Fetoprotein,縮寫AFP;又譯甲種胎儿球蛋白或甲胎蛋白)是一種α-1球蛋白,由胎兒腸胃道、卵黃囊及肝臟分泌,但可經由腎臟排入尿液、羊水,並通過胎盤進入母體血流中。在正常妊娠時,胎兒血清中之胎兒蛋白濃度於12至14週間達到最高,而母體血清中之濃度則於28至32週間達到最高。如果羊水或母體血清中的α-胎兒蛋白超出正常範圍,需考慮胎兒發育異常,例如:神經管缺損、先天性腎病變、腸道閉鎖、死胎、胎兒窘迫等。也就是說,α-胎兒蛋白雖是一項非特異指標,但對於產前評估胎兒健康狀態甚具臨床價值,也是幫助檢查胎兒異常的一項篩檢工具。
許多肝病皆可能伴隨α-胎兒蛋白之升高,因此可作為臨床參考。例如80%-90%的肝細胞癌病人,其血液中的α-胎兒蛋白有升高之現象,故在肝病甚為流行的區域(如臺灣),利用α-胎兒蛋白及超聲波作為高危險群病人篩檢方式,成效良好。再如肝硬化病人當中有些合併有α-胎兒蛋白之升高,這可能代表肝細胞再生的持續進行;但若持續上升則須積極追蹤,找出可能的惡性變化。此外,急慢性肝炎患者血中的α-胎兒蛋白常隨著肝細胞壞死後之再生而升高。其高峰往往在轉氨基的高峰之後;其升高程度間接地反映肝細胞壞死後的再生能力,也因此常被利用作為病理變化及病程預後之參考。
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