How to check liver cancer to eliminate hidden dangers. 4 physical examination items are recommended for diagnosing liver cancer

Liver cancer is one of the top three cancers that are very scary now. So do you know what are the examination methods for liver cancer? What is the best treatment?

Liver cancer is a common liver disease. The occurrence of this disease will have a certain impact on the patient's physical health. If the condition is serious, it will also affect the patient's life and health, and bring the patient the bad news of death. Therefore, the treatment of this disease is very important and requires the right treatment method. So, what is the best way to check liver cancer?

What tests should be done for liver cancer

1. B-mode ultrasound

B-ultrasound is easy to operate and low in cost. It can detect most liver space-occupying lesions and is the most commonly used examination method for diagnosing early liver cancer. However, the accuracy of B-ultrasound is low for smaller nodules (diameter <1 cm). At this time, other imaging examinations should be combined to confirm the diagnosis, such as CT, MRI (magnetic resonance imaging), etc.

2. Alpha-fetoprotein (AFp)

AFP is currently one of the most specific methods for diagnosing hepatocellular carcinoma. It plays a positive role in diagnosis, judging efficacy, estimating prognosis, and preventing recurrence, and is often used as an auxiliary examination for B-ultrasound and CT. When AFp200ug/L, continues to rise for more than 2 months, and excludes pregnancy, active liver disease, gonadal embryonic tumors and other diseases, liver cancer can be diagnosed in combination with imaging examination results. However, it should be reminded that AFP cannot diagnose all liver cancers, because 30%-40% of liver cancer patients test negative for AFp. For these patients, B-ultrasound, CT and other related examinations should be used. If necessary, hepatic artery angiography or B-ultrasound-guided puncture biopsy can be used to confirm the diagnosis.

3. Ultrasound examination

Ultrasound examination is an early detection method for liver cancer, and its detection rate for liver cancer lesions is very high. It is easy to operate and has relatively low cost.

4. Nuclear Magnetic Resonance

Magnetic resonance imaging is a rapidly developing method in recent years. With the continuous development of MRI technology, the scanning time is getting faster and faster, and the resolution is getting higher and higher. It can also be used as a relatively accurate judgment for some small lesions in the liver. Now MRI is also a relatively important method for early detection of liver cancer.

Treatments for liver cancer

1. Surgery

Surgical resection is still the first choice for the treatment of liver cancer. Early resection is the key to improving survival rate. The smaller the tumor, the higher the five-year survival rate. The indications for surgery are:

① The diagnosis is clear and the lesion is estimated to be limited to one lobe or half of the liver;

② No obvious jaundice, ascites or distant metastasis;

③ Those whose liver function is well compensated and whose thrombin time is not less than 50%;

④ Patients with heart, liver, and kidney function tolerance. For patients with normal liver function, the amount of liver resection should not exceed 70%; for patients with moderate cirrhosis, the amount of liver resection should not exceed 50%, or only the left hemihepatectomy can be performed; for patients with severe cirrhosis, liver lobectomy cannot be performed. Surgery and pathology have confirmed that more than 80% of liver cancer is complicated by cirrhosis. It is generally recognized that local resection instead of regular liver lobectomy has the same effect, and the liver function disorder is alleviated after surgery, and the surgical mortality rate is also reduced. Since radical resection still has a high recurrence rate, it is advisable to regularly check AFp and ultrasound imaging after surgery to monitor recurrence.

Due to the close follow-up after radical resection, subclinical recurrence of small liver cancer is often detected, so reoperation is the first choice. The five-year survival rate after the second operation can still reach 38.7%. Although liver transplantation is a method of treating liver cancer, and there are many reports abroad, its status in the treatment of liver cancer has not been confirmed for a long time. The long-term use of immunosuppressants after surgery often causes patients to die from recurrence. For developing countries, it is still difficult to promote it in recent years due to the source of donors and cost issues.

2. Palliative surgical treatment

It is suitable for patients with larger tumors or those scattered or close to large blood vessels, or those with cirrhosis that restricts resection. Methods include hepatic artery ligation and/or hepatic artery catheterization chemotherapy, cryosurgery, laser therapy, microwave therapy, intraoperative hepatic artery embolization therapy or intratumoral injection of anhydrous alcohol, etc., which can sometimes shrink the tumor and reduce serum AFp, providing an opportunity for a second-step resection.

3. Multimodal comprehensive treatment

It is an effective treatment method for large liver cancer in the middle stage in recent years, and sometimes it can transform large liver cancer that cannot be removed into a small liver cancer that can be removed. There are many methods, generally based on the dual method of hepatic artery ligation and hepatic artery catheterization chemotherapy, plus external radiation therapy for triple therapy, such as combined with immunotherapy quadruple therapy. The effect is best with triple therapy or above. After multi-modal comprehensive treatment, the tumor reduction rate of patients reached 31%. Because the tumor was significantly reduced, they were resected in two steps, and the two-step resection rate reached 38.1%. The Liver Cancer Research Institute of Shanghai Medical University has also studied hyperfractionated radiotherapy and guided therapy. The method of combined treatment of hyperfractionated external radiation and hepatic artery catheterization chemotherapy is: in the first week, hepatic artery catheter chemotherapy cisplatin (CDDp) 20 mg per day for 3 consecutive days. In the second week, local external radiation of the liver tumor area is 2.5Gy (250rads) in the morning and afternoon for 3 consecutive days; two weeks is a course of treatment, and it can be repeated 3 to 4 courses every other week. Guided treatment, 131I-anti-liver cancer ferritin antibody or anti-liver cancer monoclonal antibody or 131I-lipiodol is injected into the hepatic artery catheter every 1 to 2 months, and CDDp 20mg is injected into the artery once a day during the treatment interval for 3 to 5 consecutive days. It is better if the above treatment is combined with immunotherapy such as interferon, lentinan, interleukin-2, etc.

4. Transarterial chemoembolization (TAE)

This is a non-surgical tumor treatment method developed in the 1980s. It has a good effect on liver cancer and is even recommended as the first choice among non-surgical treatments. It is often used to embolize the distal blood supply of the tumor with iodized oil (lipiodol) mixed with chemotherapy drugs or 131I or 125I-lipiodol, or 90 yttrium microspheres, and then use gelatin sponge to embolize the proximal hepatic artery of the tumor, making it difficult to establish collateral circulation, resulting in ischemic necrosis of the tumor lesion. Chemotherapy drugs commonly used are CDDp80~, plus 100mg5Fu1000mg mitomycin 10mg [or doxorubicin (ADM) 40~60mg], first intra-arterial infusion, and then mixed with mitomycin (MMC) 10mg in ultrasonic emulsified Lipiodol for distal hepatic artery embolization. Hepatic artery embolization chemotherapy should be repeated for multiple times for better results. According to the data, among 345 patients with large liver cancer that could not be surgically removed, the one-year survival rate of hepatic artery infusion chemotherapy alone was only 11.1%, while that of combined hepatic artery embolization therapy increased to 65.2%, with the longest follow-up survival being 52 months. 30 patients had tumor shrinkage and were given the opportunity for surgical resection. This method is contraindicated for patients with severe liver decompensation and is also not suitable for patients with portal vein thrombosis.

5. Intratumoral injection of anhydrous alcohol.

Ultrasound-guided percutaneous liver puncture and injection of anhydrous alcohol into the tumor are used to treat liver cancer. The first choice is for patients with tumor diameter ≤3cm, nodules less than 3, and liver cancer with cirrhosis that cannot be operated on. Small liver cancer may be cured. ≥5cm has poor effect. (Reference website: Anti-cancer Health Network)