Why does jaundice occur in the late stage of liver cancer

A 58-year-old female patient with advanced liver cancer and a history of hepatitis B is now turning yellow all over and cannot eat. Why is her whole body turning yellow?

The yellowing of the patient's entire body is clinically called jaundice, which refers to hyperbilirubinemia, that is, the increase in bilirubin concentration in the blood, causing the skin, mucous membranes, sclera and other tissues and body fluids to become yellow.

Jaundice is a common sign of advanced liver cancer, and diffuse liver cancer and cholangiocarcinoma are most likely to cause jaundice.

The main causes of hepatocellular carcinoma jaundice are:

Jaundice can be divided into three types: hemolytic jaundice, hepatocellular jaundice and obstructive jaundice. The jaundice complicated by liver cancer patients belongs to the latter two types, with obstructive jaundice being the most common. The specific mechanism of occurrence is as follows:

1. Intrahepatic tumor invades the bile duct and causes obstruction

Intrahepatic tumors invade the bile duct, causing incomplete or complete obstruction of the bile duct, and may partially necrotize and fall off, descending into the extrahepatic bile duct, suddenly blocking the bile duct and causing obstructive jaundice.

2. Cancer compresses the bile duct, causing poor bile drainage

Tumor nodules in the liver and hilar area or enlarged hilar lymph nodes compress the bile ducts at all levels, resulting in poor bile drainage, reflux of conjugated and unconjugated bilirubin into the blood, and increased blood bilirubin concentration, with conjugated bilirubin as the main component, causing obstructive jaundice.

3. Tumor thrombus in the bile duct blocks the bile duct

The formation of tumor emboli in the bile duct, including the shedding of necrotic tumors, growth in the bile duct, rupture of primary tumors in the liver into the bile duct, or tumor bleeding, blood clots containing cancer cells forming emboli, blocking the bile duct, etc., can all lead to obstructive jaundice.

4. Mixed jaundice

Diffuse liver cancer or combined with severe liver cirrhosis, due to extensive damage to liver cells, the production, metabolism and excretion of bilirubin in the liver are impaired, resulting in increased levels of conjugated and unconjugated bilirubin in the blood, causing hepatocellular jaundice. At the same time, it can also be combined with obstructive jaundice and mixed jaundice due to the compression of the biliary system by the intrahepatic tumor.

5. Therapeutic jaundice

Some anti-liver cancer treatments can also cause jaundice, such as hepatic artery chemoembolization, percutaneous anhydrous ethanol injection or external radiotherapy, but the mechanism is not yet fully understood.