What are the early symptoms of liver cancer? Teach you how to diagnose early liver cancer

Cancer that originates in the liver is called primary liver cancer, which is one of the most common cancers in China. Cancer that originates in other organs and metastasizes to the liver is called secondary liver cancer. All kinds of cancers, when developed to a certain extent, have the potential to metastasize to the liver.

If you find any of the following symptoms, you should be alert.

① Patients with a history of hepatitis should be carefully examined if the pain in the liver area suddenly worsens or the nature of the pain changes.

② Patients with a history of liver cirrhosis should also be examined if symptoms suddenly worsen.

③Manifestations in the liver area: pain in the liver area, which usually worsens after exertion, or discomfort in the liver area, or discomfort in the right shoulder, etc.

④ Manifestations of the digestive tract: Upper abdominal distension, aggravated distension after eating, stomach discomfort, or dull pain in the stomach area may sometimes be mistaken for stomach problems, resulting in delayed treatment. Umbilical pain, loose stools, or increased frequency of stools may sometimes be mistaken for enteritis and require careful examination. Discomfort in the right upper abdomen, sometimes aggravated by eating greasy food, may be mistaken for cholecystitis and also require differentiation.

⑤ Systemic manifestations: such as weight loss, fatigue, low fever in the afternoon, and night sweats.

⑥Other symptoms: When there is jaundice, the urine is very yellow, even red, and the whites of the eyes are yellow. When there is ascites, there is abdominal distension, less urine, shorter urine flow, and more frequent bowel movements. When there is gastrointestinal bleeding, the stool is black and tarry, or even vomiting blood. When there is liver cancer rupture, there is severe abdominal pain, hemoperitoneum, and even a drop in blood pressure. When there is a drop in blood sugar, there is paroxysmal sweating and fainting. When there is liver fainting, there is mania, fainting, convulsions, etc.

How to diagnose common liver tumors

1. Secondary liver cancer

Many tumors may metastasize to the liver. In Western countries, secondary liver cancer is much more common than primary liver cancer. Secondary liver cancer is most common, followed by lung, pancreas, colon and breast cancer, etc., and should be carefully differentiated. Secondary liver cancer generally develops relatively slowly, and most have clinical manifestations of primary cancer, and the alpha-fetoprotein test is negative. The key to differentiating it from primary liver cancer is to identify the primary cancer focus.

2. Active liver disease and cirrhosis

Acute or chronic active liver disease may cause transient increase in alpha-fetoprotein, and dynamic observation of alpha-fetoprotein and transaminase measurement should be performed. If the dynamic curves of the two are parallel or synchronous, or alanine aminotransferase (GpT) continues to increase, active liver disease is likely; if the two curves are separated, that is, alpha-fetoprotein increases and GpT decreases, primary liver cancer should be considered.

It is often difficult to differentiate between primary liver cancer and cirrhosis. If a patient with cirrhosis has pain in the liver area, an enlarged liver, increased alpha-fetoprotein (even if the increase is in low concentrations), etc., the possibility of cancer is very high, and B-ultrasound examination and hepatic angiography should be performed in time to confirm the diagnosis.

3. Liver abscess

Liver abscesses have inflammatory symptoms such as fever and increased white blood cell count. The chest wall at the site of the abscess often has localized edema, tenderness, and right upper abdominal muscle tension. Multiple ultrasound examinations can reveal fluid-level segments or fluid-dark areas of the abscess, but fluid-level segments can also occur in liver cancer fluid necrosis, so they should be distinguished. If necessary, fine needle puncture can be performed at the tender point. During enhanced CT examination, liver abscesses may show peripheral enhancement characteristics.

4. Hepatic cavernous hemangioma

Hepatic cavernous hemangioma is a benign space-occupying lesion in the liver, which is often discovered accidentally due to physical examination, B-ultrasound examination or radionuclide imaging examination. This disease is common in my country. Differential diagnosis mainly relies on alpha-fetoprotein determination, B-ultrasound examination and hepatic angiography. Hepatic angiography of hepatic cavernous hemangioma has the following main characteristics: ① The thickness of the hepatic blood vessels is normal, and there may be vascular displacement when the tumor is large; ② There is no arteriovenous communication; ③ The portal vein is normal and there is no cancer thrombus; ④ The blood pool shadow continues to the venous phase and becomes a dense shadow with high concentration. The distribution of the blood pool outlines the size and shape of the cavernous hemangioma as its characteristic manifestation.

5. Hepatic echinococcosis

Patients with hepatic echinococcosis (liver echinococcosis) have progressive liver enlargement, hard texture and nodular feeling; in the late stage, most of the liver is destroyed, and the clinical manifestations are very similar to primary liver cancer. However, this disease generally has a long course, with a history of 2 to 3 years or longer, and progresses slowly. It can be distinguished from liver cancer by various tests such as living in an endemic area, positive skin test for hepatic echinococcosis fluid, and negative alpha-fetoprotein.

6. Extrahepatic tumors adjacent to the liver

Retroperitoneal soft tissue sarcomas, as well as tumors from the kidney, adrenal gland, pancreas, colon, etc., can also present as masses in the right upper abdomen. Ultrasound examination helps to distinguish the location and nature of the mass. The alpha-fetoprotein test is usually negative. When differentiation is difficult, laparotomy is required for diagnosis.