How to check and diagnose liver cancer? Beware of these diseases that are easily misdiagnosed as liver cancer

Liver cancer is a common cancer and a daunting disease. It brings a lot of pain to people both physically and mentally. So, how to diagnose liver cancer? And what diseases are easily misdiagnosed as liver cancer?

What tests are needed to diagnose liver cancer?

1. Liver function test: Liver function test should be performed on patients with liver cancer. Most of them are normal. Liver function damage may occur when accompanied by cirrhosis. Some patients have high serum alanine aminotransferase. Liver function damage caused by liver cancer is only seen in patients in the late stage.

2. Ultrasound examination: Ultrasound examination is also a means of diagnosing liver cancer. The characteristics of ultrasound are that it is relatively easy to operate, the cost is relatively low, and the detection rate of liver lesions is also relatively high.

3. CT. CT examination is a crucial means of examining liver cancer and is performed quite frequently across the country.

4. Alpha-fetoprotein test to see if there are tumor markers. Alpha-fetoprotein has a certain sensitivity for the test. However, we have also found clinically that the alpha-fetoprotein of some patients is not necessarily high. The alpha-fetoprotein of patients with liver cancer can be high, but patients with low alpha-fetoprotein cannot completely rule out the possibility of liver cancer.

5. Angiography, although it has a high diagnostic accuracy for liver cancer, is invasive. First, an incision must be made in the femoral artery, and a tube must be inserted into the femoral artery and all the way to the hepatic artery to visualize the tumor blood vessels. Hepatic artery angiography is not the first choice because it is invasive. Now it is more commonly used as a treatment, which is what we usually call interventional therapy. It is performed through the hepatic artery lesion, and anti-cancer drugs are directly injected into the tumor blood vessels through a catheter to achieve a therapeutic effect.

6. Magnetic resonance imaging: Magnetic resonance imaging is a new and valuable diagnostic method for liver cancer. It is similar to CT in terms of qualitative analysis - about 95%, and is also expensive. Currently, ultrasound examination is usually performed first, and CT or MRI is used for reexamination and identification if problems are found.

7. Liver biopsy: Liver biopsy can be performed under B-ultrasound or isotope positioning, with a positive rate of 76.1% to 92.3%. In addition, ascites can be drawn to find cancer cells, metastatic lymph nodes can be biopsied, and laparotomy can be performed to obtain biopsies. I would like to add that the patient Chen in this book did not find cancer cells during the surgical exploration and biopsy, but clinical evidence confirmed that he had advanced liver cancer at the time.

Beware of diseases that can be easily misdiagnosed as liver cancer

Granuloma: Some female patients may have isolated, smooth, and complete nodules in the liver due to oral contraceptives, parasitic infections, or autoimmune disorders, which are difficult to distinguish from liver cancer on imaging. Ultrasound or CT-guided histological examination is recommended.

Cirrhosis nodules: Cirrhosis nodules are most likely to be diagnosed as liver cancer, because most primary liver cancers will develop into cirrhosis, and patients with severe cirrhosis will have a large number of hyperplastic nodules, which are difficult to distinguish from early liver cancer. It is recommended to perform an ultrasound or CT-guided puncture biopsy for accurate diagnosis.

Liver abscess: Patients have clinical manifestations such as fatigue, low fever, weight loss, and discomfort in the liver area. It is difficult to differentiate from liver cancer in the early stages of the disease and requires a comprehensive judgment based on biochemical indicators such as blood routine, AFp, and liver function.

Hepatic hemangioma: Hepatic hemangioma is easily confused with hepatocellular carcinoma. In fact, hemangioma grows slowly and generally has no history of chronic liver disease. There are no clinical manifestations such as fatigue, poor appetite, abdominal distension, etc., and there will be no physical signs such as liver palms, spider nevi, jaundice, and edema of both lower limbs.

Uneven fatty liver: Some patients with fatty liver have uneven fat accumulation, which is sometimes difficult to distinguish from liver cancer. Clinically, fatty liver does not have the systemic manifestations of liver cancer patients, such as abdominal distension, diarrhea, discomfort in the right liver area, and weight loss.