How can liver cancer be detected

How can liver cancer be detected? In the examination of liver tumors, the continuous development of serology and imaging has provided various methods for the early diagnosis of subclinical liver cancer. Clinically, serological diagnosis and imaging diagnosis are called positioning diagnosis. The comprehensive application of these methods can improve the accuracy of diagnosis. The specific examination methods for this disease are as follows.

1. Alpha-fetoprotein (AFP) test

The accuracy of AFP for liver cells is about 90%, and its clinical value is as follows.

1. Early diagnosis: It is possible to diagnose subclinical lesions and make a diagnosis about 8 months before the onset of symptoms.

2. Differential diagnosis: Since 89% of hepatocellular carcinoma patients have serum AFP greater than 20 ng/ml, liver cancer can be ruled out if the AFP is lower than this value and there is no other evidence of liver cancer.

3. It helps to reflect the improvement or deterioration of the condition. An increase in AFP indicates deterioration, while a decrease indicates improvement if the clinical condition also improves.

4. It helps to judge the thoroughness of surgical resection and predict recurrence. If AFP drops to normal values ​​after surgery, it indicates complete resection, while if it drops and then rises again, it indicates recurrence. It can also predict recurrence 6 to 12 months before the onset of recurrence symptoms.

5. It helps to evaluate various treatment methods. The higher the AFP negative conversion rate after treatment, the better the effect.

AFP false positive, not all AFP positive patients have liver cancer, AFP false positive is mainly seen in hepatitis and liver cirrhosis, both of which account for 80% of false positive cases. In addition, there are gonadal embryonal carcinoma, digestive tract cancer, pathological pregnancy, hepatic hemangioendothelioma, malignant liver fibroma, etc. In the diagnosis of AFP negative patients, when AFP negative cannot exclude the diagnosis of liver cancer, enzyme examination can be performed, among which the more clinically significant ones are α1 antitrypsin (AAT), γ-glutamyl transpeptidase (γ-GT), carcinoembryonic antigen (CEA), alkaline phosphatase (AKP), etc. These serological test results may increase in patients with liver disease, but they are not specific.

2. Liver biopsy

If the diagnosis is basically clear, liver puncture is not necessary, because liver puncture has certain complications, the most common of which is bleeding. In addition, during liver puncture, the puncture needle will pass through the portal vein or hepatic vein and bile duct. In this case, cancer cells may be brought into the blood vessels and cause metastasis.

3. B-ultrasound

It can show tumors larger than 1 cm, with a diagnostic accuracy of 90%, and can show tumor size, location, shape, number, hepatobiliary duct, portal vein, spleen, abdominal lymph nodes, etc. It can also diagnose the presence or absence of liver cirrhosis, splenomegaly and ascites.

CT

The diagnostic accuracy of liver cancer is 93%, and the minimum resolution is 1.5 cm. Its advantage is that it can directly observe the size and location of the tumor and its relationship with the hepatic vein and portal vein, and can diagnose whether there is cancer thrombus in the portal vein or hepatic vein.

5. Angiography

Hepatic artery angiography can help understand the blood supply of the lesion to determine the possibility and indication of surgery. It can show tumors of about 1.5 cm and is the most resolvable imaging diagnostic method. It is also important for identifying hepatic hemangiomas. While clarifying the diagnosis, it can also help understand whether the hepatic artery has any mutations, which is very helpful for liver resection. If it is mid-to-late stage liver cancer and cannot be treated surgically, embolization or chemotherapy can be given.

6. Comparison between MRI and CT

Basically the same, but helpful for some liver masses that are difficult to identify.

7. Radionuclide Scanning

For patients who are difficult to differentiate from hemangiomas, blood flow scanning can be used for differentiation. However, due to the low resolution of radiation scanning, it is rarely used as a diagnostic method for liver cancer.

8. Laparoscopy

In patients who are difficult to diagnose, laparoscopy can be considered to directly observe the liver, tumors on the liver surface, and the conditions in the abdominal cavity.

IX. X-ray examination

X-ray fluoroscopy showed elevation of the right diaphragm, limited movement or localized protrusion. In 30% of cases, calcification shadows were seen in the tumor on X-ray films. About 10% of cases had lung metastases at the time of diagnosis.