What are the examination methods for liver cancer? Six blood test indicators for liver cancer

1. Serum fucosidase (AFu)

AFu belongs to the lysosomal acid hydrolase class, and its main physiological function is to participate in the degradation of bioactive macromolecules such as glycoproteins and glycolipids containing fucose. Primary liver cancer should be considered when AFu exceeds 110nKat/L. The sensitivity and specificity of diagnosing primary liver cancer are 75%, 90%, and the positive rate for AFp-negative liver cancer and small liver cancer is more than 70%. Secondary liver cancer and benign liver occupying lesions are all negative, but the false positive rate of chronic hepatitis with cirrhosis is high.

2. Alpha 1-antitrypsin (AAT)

Hepatocellular carcinoma cells have the ability to synthesize and secrete AAT, which increases when the tumor is combined with cell necrosis and inflammation.

3. Alkaline phosphatase isoenzyme I (ALp-I)

ALp-I is an oncofetal protein produced by liver cancer cells and is found almost exclusively in liver cells. It has a high specificity for liver cancer but a low positive rate.

4. Serum ferritin and acidic isoferritin (HIF)

The liver contains a lot of ferritin and is the main site for clearing ferritin from the circulation. In liver disease, ferritin escapes from damaged liver cells, and the liver's ability to process ferritin decreases, resulting in increased ferritin concentrations in serum. Isoferritin is of certain significance in the diagnosis of liver cancer because liver cancer cells synthesize more ferritin and release it faster in liver cancer.

Some scholars believe that serum ferritin has moderate sensitivity and specificity for liver cancer. Although its specificity is lower than AFp, it has diagnostic significance for those with negative AFp. If both AFp and ferritin are negative in patients with cirrhosis, the possibility of liver cancer is extremely small. Elevated ferritin can often detect small liver cancer, cirrhosis and other diseases in patients with low AFp content, negative HBsAg and a history of alcoholism. Although serum ferritin can be elevated, it is often accompanied by elevated serum iron and transaminase, which can be used for identification. Therefore, simultaneous determination of AFp and serum ferritin is a very valuable method for detecting liver cancer in high-risk populations with cirrhosis.

5. Aldolase isoenzyme A (ALD-A)

There are three forms of aldolase isoenzymes, A, B, and C. Type A is mainly found in muscle and fetal liver tissue, while type B is the main form in normal liver tissue. When hepatocellular carcinoma occurs, ALD-A reappears and gradually replaces ALD-B. The ALD-A positivity rate in hepatocellular carcinoma is 76%, and the poorer the differentiation of hepatocellular carcinoma, the stronger the AID-A positive reaction. After surgical resection of the tumor or embolization therapy, the ALD-A concentration decreases. The positive rate of AFp-negative liver cancer is > 70%.

6. M2 pyruvate kinase (M2-pyK)

Pyruvate kinase (pyK) is a key enzyme in glycolysis, and there are four types, LRM1M2. The isoenzyme in fetal liver and liver cancer tissue is mainly M2 type, which can be regarded as a carcinoembryonic protein. The ELISA sandwich method can detect trace amounts at the pg level, and the highly sensitive cancer marker has increased significantly in the small liver cancer stage. The poorer the differentiation, the more obvious the increase in M2-pyK value. It can also be increased in digestive tract tumors, but not in benign liver tumors caused by hepatitis.

In summary, liver cancer blood markers are of great significance for the diagnosis of primary liver cancer. According to clinical diagnostic experience, combined detection is better than single detection. Serum AFp detection combined with 1 to 2 liver cancer markers can significantly increase the positive detection rate of primary liver cancer. In clinical analysis, comprehensive judgment should be made in combination with medical history, imaging diagnosis or histological data to obtain accurate diagnostic results.