How to diagnose primary liver cancer? This test can diagnose primary liver cancer

Alpha-fetoprotein (α-fetoprotein, αFp or AFp) is mainly synthesized in the fetal liver, with a molecular weight of 69,000. At 13 weeks of pregnancy, AFp accounts for 1/3 of the total plasma protein. It reaches its peak at 30 weeks of pregnancy, and then gradually decreases. The plasma concentration at birth is about 1% of the peak, about 40 mg/L, and is close to the adult level (less than 30 μmg/L) at one year old.

Alpha-fetoprotein AFp in the amniotic fluid or maternal plasma can be used for fetal prenatal monitoring. For example, in cases of neural tube defects, spina bifida, anencephaly, etc., AFp can enter the amniotic fluid through the open neural tube, resulting in a significant increase in its content in the amniotic fluid. Congenital defects such as intrauterine fetal death and teratoma can also cause an increase in AFp in the amniotic fluid. AFp can partially enter the maternal blood circulation through the amniotic fluid. In 85% of mothers with spina bifida and anencephaly, plasma AFp can be seen to increase at 16-18 weeks of pregnancy and has diagnostic value, but it must be combined with clinical experience to avoid false positive errors.

In adults, AFp can be elevated in the serum of about 80% of liver cancer patients, and the positive rate of AFp in germ cell tumors is 50%. It can also be elevated to varying degrees in patients with other gastrointestinal tumors such as pancreatic cancer or lung cancer and liver cirrhosis.

AFP is a glycoprotein, abbreviated as AFp. Under normal circumstances, this protein mainly comes from the liver cells of the embryo. It disappears from the blood about two weeks after the fetus is born, so the AFP content in normal human serum is less than 20 micrograms/liter. However, when liver cells become cancerous, they regain the function of producing this protein, and as the disease worsens, its content in the serum increases sharply. AFP has become a specific clinical indicator for diagnosing primary liver cancer.

There are several methods for detecting alpha-fetoprotein. If the alpha-fetoprotein measured by radioimmunoassay is greater than 500 micrograms/liter and lasts for 4 weeks, or the alpha-fetoprotein is between 200 and 500 micrograms/liter and lasts for 8 weeks, after excluding other factors that cause increased alpha-fetoprotein, such as acute and chronic hepatitis, post-hepatitis cirrhosis, embryonal tumors, and digestive tract cancer, it is necessary to combine positioning examinations such as B-ultrasound, CT, magnetic resonance imaging (MRI), and hepatic angiography to make a diagnosis. However, alpha-fetoprotein will also increase in women with normal pregnancy, a few cases of hepatitis and cirrhosis, and gonadal malignancies, but the increase is not as high as that of liver cancer. The serum alpha-fetoprotein concentration of patients with cirrhosis is mostly between 25 and 200 micrograms/liter, and generally decreases within 2 months as the condition improves, and most of them will not exceed 2 months; at the same time, it is accompanied by increased transaminase. When the transaminase decreases, the alpha-fetoprotein also decreases. The serum alpha-fetoprotein concentration is often parallel to the transaminase. If the alpha-fetoprotein concentration is above 500 micrograms/liter, although the transaminase is elevated, the possibility of liver cancer is high. If the transaminase decreases or stabilizes, while the alpha-fetoprotein increases, liver cancer should also be highly suspected.

Alpha-fetoprotein increases 8 months before the onset of symptoms of liver cancer. At this time, most liver cancer patients still have no obvious symptoms and their tumors are relatively small. The prognosis of these patients can be significantly improved after surgical treatment. Therefore, patients with cirrhosis, chronic hepatitis, and those with liver cancer in their families should be tested every six months.

Check the liver cancer marker, alpha-fetoprotein (AFp). Before B-ultrasound, CT, or MRI finds a liver mass, AFp will be significantly elevated, which means that primary liver cancer can be found at an ultra-early stage. This is currently recognized by the medical community as the most effective method for finding primary liver cancer, and it is also a mature technology. Qualitative examinations can be done at county-level hospitals, but a positive result does not necessarily mean liver cancer. It also depends on how high the AFp concentration is, which requires a quantitative AFp test.