What is the best way to check liver cancer? There are 3 routine items to check liver cancer

For people at high risk of liver cancer, timely detection of liver cancer is more important than treatment. So do you know what are the items in liver cancer physical examination?

Liver cancer is a very common tumor disease. The occurrence of this disease not only causes great harm to the patient's body, but also causes serious trauma to the patient's family. Therefore, when we suffer from this disease in our daily life, we need to diagnose and treat it as soon as possible. Experts say that early detection of liver cancer is very important for the accurate treatment and prognosis of the disease. Therefore, everyone must choose a regular hospital during treatment to avoid misdiagnosis and mistreatment. The following is a relevant introduction to liver cancer examination items, I hope it will be helpful to you.

Common liver cancer screening items are as follows:

(I) Angiographic diagnosis

Selective hepatic angiography is usually performed. Since this method is invasive and has poor visualization of oligovascular liver cancer and left lobe liver cancer, it is only used when ultrasound and CT have not yet been able to confirm the diagnosis.

(II) Ultrasound diagnosis

Ultrasound imaging is the preferred method for localization diagnosis of liver cancer and has auxiliary qualitative value. It can also be used in conjunction with AFp screening to detect subclinical liver cancer and small liver cancer at an early stage. Its detection limit is about 1 cm. The B-ultrasound manifestations of typical liver cancer are ring sign, mosaic sign and tumor thrombus. The tumor presents four types: high echo, equal echo, low echo and mixed type. According to the shape of the tumor, it is divided into nodular type, massive type and diffuse type. Tumor thrombus in the branch or trunk of the portal vein has auxiliary diagnostic value for HCC. Color ultrasound examination can also provide blood supply of space-occupying lesions, which is helpful for distinguishing hepatocellular carcinoma from benign space-occupying lesions of the liver. Ultrasound-guided liver biopsy is not only of diagnostic significance, but also can be used for differential diagnosis and detection of smaller liver cancer. Ultrasound Doppler detection is a new technology developed in recent years. It can detect thickening of the proper hepatic artery, color blood flow surrounding the tumor, color blood flow in the tumor parenchyma, increased local and (or) total blood flow in the tumor lesion, and the presence of arterio-portal vein fistula.

Hepatocellular carcinoma should be differentiated from cholangiocarcinoma, metastatic liver cancer, hepatic vascular carcinoma, and regenerative nodules of cirrhosis. Lesions with a diameter of 2 cm or less should be differentiated from hepatic hemangioma and metastatic liver cancer.

The sensitivities of B-ultrasound, X-ray, CT and AFP are about 90%, 90% and 75% respectively. If the two are used in combination, the detection rate can reach nearly 100%. Even the use of B-ultrasound alone or combined with ultrasound-guided biopsy can basically solve the diagnosis problem of liver cancer with a tumor diameter of ≥2 cm.

3. Computerized tomography (CT)

CT has become a routine localization examination method for liver cancer, and its detection limit is 1~2cm. HCCCT image performance: (1) Nodular type: appears as a low-density mass with uneven internal density. On plain scan, it is a ring-shaped low-density area, and after enhancement, it shows uneven enhancement. (2) Massive type: It appears as a low-density area with unclear edges, and most of them are clearer after enhancement. (3) Diffuse type: The entire liver is filled with countless small tumor nodules surrounded by connective tissue, showing low-density masses of varying sizes. (4) Small liver cancer and sub-nodules appear as low- to isodense circular lesions. After injection of contrast agent, the lesions are significantly enhanced, lasting 23~33s, and then low density reappears. Portal angiography CT (CTAp) can significantly improve the diagnostic rate, and the detection rate of cancer lesions with a diameter of less than 1cm can reach 75%~80%. Spiral CT is the most sensitive and preferred for CTAp. Iodized oil CT, that is, delayed CT (7-14 days) after iodized oil is injected through the hepatic artery, may detect small liver cancers of 0.5 cm, which appear as images with obvious iodized oil concentration. HCC should be mainly differentiated from hepatic hemangioma, atypical hyperplasia and benign glandular hyperplasia.

How is liver cancer diagnosed?

1. Alpha-fetoprotein (AFp): Alpha-fetoprotein is a specific tumor marker for diagnosing primary liver cancer, which plays a role in establishing diagnosis, early diagnosis, and differential diagnosis. It is especially used in the diagnosis of early subclinical liver cancer and timely surgery can greatly improve the survival rate of patients.

2. Serum ferritin (SF): It is the second serological marker for primary liver cancer. If alpha-fetoprotein and serum ferritin are measured together, the positive rate of any one of them as a diagnostic indicator is as high as 92.1%. Especially when the alpha-fetoprotein concentration is low or negative, the serum ferritin measurement is quite meaningful. Therefore, the combined application of serum ferritin and alpha-fetoprotein will further improve the early diagnosis rate of primary liver cancer.

3. Alkaline phosphatase: The serum alkaline phosphatase of patients with liver cancer is often elevated, with a positive rate of 65%. In addition, patients with obstructive jaundice have disproportionately elevated alkaline phosphatase, indicating the possibility of liver cancer.

4. r-glutamyl transpeptidase (r-GT): The positive rate of liver cancer patients is 84.2% to 91.2%. The increase of this enzyme may mainly come from the tumor itself.

5. Ultrasonic examination: Ultrasonic examination is the main method for diagnosing primary liver cancer. B-ultrasound uses ultrasonic tomography, which is shown on the sonogram as a solid dark area of ​​the tumor surrounded by obvious reflected light spots, light groups, and light bands. Ultrasonic diagnosis is simple to operate, non-invasive, and has high resolution. It has certain value in the diagnosis and location of primary liver cancer.

6. CT examination and MRI examination: CT examination has high resolution and can detect smaller tumors, which is of practical value in the diagnosis of liver cancer. MRI is a new and valuable diagnostic method for liver cancer, which is qualitatively different from CT.

7. Liver biopsy: It 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. (Reference website:)