How to confirm the diagnosis of liver cancer

Elevated alpha-fetoprotein is an important reference factor for diagnosing liver cancer. If elevated alpha-fetoprotein is found, or ultrasound examination reveals space-occupying lesions in the liver, the diagnosis of liver cancer must be confirmed through correct methods and approaches.

If alpha-fetoprotein is found to be elevated, especially when it exceeds 400 μg/L, ultrasound examination, CT examination, or imaging examination such as MRI must be performed. If imaging examination shows space-occupying lesions in the liver that are consistent with the characteristics of liver cancer, such as dynamic enhanced CT showing significant enhancement in the arterial phase and typical low density in the venous phase, then a clinical diagnosis of liver cancer can be made.

If the imaging examination does not find liver cancer, it is necessary to identify the cause of the elevated AFP. The first thing to consider is whether the elevated AFP is caused by hepatitis activity, and liver function should be checked. If the changes in AFP are consistent with the changes in ALT, that is, as ALT decreases, AFP also decreases, and as ALT increases, AFP also increases, then the elevated AFP is caused by hepatitis activity.

Conversely, if liver function is normal but alpha-fetoprotein continues to rise, it is likely caused by tiny liver cancer, although current imaging tests have not found it.

If the patient has no history of hepatitis and cirrhosis, the elevation of alpha-fetoprotein also needs to rule out the elevation of alpha-fetoprotein caused by embryonic tumors, gonadal tumors, and gastric cancer.