Differential diagnosis of liver cancer

Differential diagnosis of liver cancer:

1. Differential diagnosis of AFP-positive liver cancer: About 2% of patients with AFP levels of 500pt/L or above are ultimately confirmed not to have primary liver cancer.

(1) AFP-positive patients with liver lesions need to be differentiated from liver metastases of gastric or pancreatic cancer, which can be ruled out through gastrointestinal examination or ultrasound imaging.

(2) AFP positive but no liver mass: It is mainly necessary to differentiate between pregnancy, testicular or yolk cleft tumors, active liver disease, etc. After pregnancy and delivery, AFP turns negative, and testicular or ovarian tumors can usually be diagnosed through physical examination or gynecological examination. However, differentiation from liver cancer is sometimes very difficult in chronic hepatitis or active cirrhosis.

2. Differential diagnosis of AFP-negative liver cancer When a liver space-occupying lesion is found and the AFP test is negative, further examination should be performed based on the medical history and physical examination.

(1) Obtain histological or cytological evidence to confirm the diagnosis

(2) If a pathological diagnosis cannot be obtained, the following steps can be used for analysis and identification: ① Identify whether the mass is located in the liver. ② Identify whether the intrahepatic tumor is liquid or solid. ③ Identify whether the intrahepatic solid mass is benign or malignant. Color Doppler blood flow imaging (color Doppler ultrasound), CT enhanced scanning and radionuclide blood pool scanning can be used for identification. ④ Identify whether the intrahepatic malignant tumor is primary or metastatic. ⑤ Identify whether the primary liver malignant tumor is liver cancer or liver sarcoma; ⑥ Identify whether the primary liver cancer is hepatocellular or cholangiocellular.