What are the common malignant tumors? How can B-ultrasound diagnosis of liver cancer be confirmed?

What are the common malignant tumors?

Carcinoembryonic antigen (CEA) is a glycoprotein molecule with a relative molecular mass of 1.8×103, named because it can be normally secreted in the embryo. Initially, abnormal expression of CEA could be detected in the serum of patients with gastric and intestinal diseases, and then gradually detected in the serum of patients with lung cancer, liver cancer, breast cancer and pancreatic cancer.

Liver cancer is one of the common malignant tumors in my country, second only to gastric cancer in the death rate of malignant tumors. The number of people who die from liver cancer in my country each year accounts for 40% of the number of liver cancer deaths in the world. It is a disease that seriously threatens life and health. The key to treating liver cancer is the "two early" principle of early diagnosis and early treatment, but liver cancer can be divided into metastatic and primary types, and the treatment methods are also very different. Primary small liver cancer is generally treated with surgical resection, while metastatic liver cancer must first find the primary site and then formulate a thorough treatment plan. Therefore, it is very important to distinguish whether liver cancer is primary or metastatic in clinical diagnosis, and the detection of serum CEA is a simple, fast and very economical means. Therefore, experts have tested the CEA content in the serum of 273 patients with primary liver cancer and 92 patients with metastatic liver cancer over the past 5 years to explore the differential diagnostic value of CEA for primary and metastatic liver cancer.

Results: The CEA of 365 patients with liver cancer was analyzed and found that the CEA positive rate (65.22%) and content (18.36±24.55) μg/L in metastatic liver cancer were significantly higher than those in primary liver cancer (17.95%) and (3.87±13.44) μg/L. In the metastatic liver cancer group, there was no statistically significant difference between the groups, but because some groups had too few cases, further data accumulation is needed.

Therefore, clinical detection of CEA content has certain guiding significance for distinguishing the type of liver cancer (primary or metastatic) and is worthy of promotion.

How to check liver cancer with B-ultrasound

(i) Liver cancer nodules with a capsule diameter of less than 3 cm often have a complete capsule. The capsule is composed of fibrous tissue, and its acoustic impedance is higher than that of the surrounding liver tissue and tumor, thus forming an interface reflection. On the two-dimensional sonogram, a thin low-echo membrane can be shown surrounding the entire tumor nodule. The thickness of the capsule is estimated to be less than 0.5 mm. On the sonogram, the capsule is relatively smooth and uniform, with a regular shape, and is round or oval. This reflects the characteristics of the expansive growth of small liver cancer. However, the capsule on the sonogram always appears interrupted on both sides of the nodule, which is the echo loss effect of the large interface. When the liver cancer is very large, its capsule is generally unclear. However, there are also cases where the capsule of the cancer nodule is greater than 5 cm in diameter and is still very complete. At this time, its inner echo is often accompanied by an acoustic halo.

(II) Internal echoes The echoes inside cancerous nodules vary in height and tend to be variable. Except for uniform low-echo nodules, the echoes of other cancerous nodules are unevenly distributed. The detection rate of liver cancer nodules 1 cm or larger by ultrasound is 33% to 37%. Cancerous nodules are classified according to the height of the echoes as follows: 1. Low-echo nodules 2. High-echo nodules 3. Mixed nodules 4. Iso-echoic nodules 5. The relationship between the height of the nodule echo and blood supply

(III) Color blood flow of cancer nodules Liver cancer nodules and their surroundings are rich in blood supply, and various blood flow information can be obtained. Second harmonic acoustic contrast imaging color Doppler ultrasound has high sensitivity in detecting tissue blood flow and can accurately reflect the blood supply of liver cancer. Color Doppler ultrasound can identify the inflow vessels, outflow vessels and intratumoral vessels of liver cancer nodules. The inflow vessels can be the hepatic artery or the portal vein. The outflow vessels can be the hepatic vein or the portal vein. The intratumoral blood vessels appear as tree-trunk-shaped, colorful dot-shaped or color-inlaid "clustered" plaques, which can be hepatic artery, portal vein or hepatic vein blood flow in spectral Doppler analysis. The blood flow around the cancer nodule can appear as a full circle or arc-shaped surround, and spectral Doppler can be used to measure whether it is continuous portal blood flow or pulsating arterial blood flow.

(IV) Lymph node metastasis 1. Lymph node metastasis in the first hepatic portal area Sonographic images show round or oval hypoechoic foci of 0.5-2 cm in size around the gallbladder neck, common bile duct, and portal vein, single or multiple. Multiple enlarged lymph nodes can cause compression of the common bile duct and jaundice. 2. Lymph node metastasis in the second hepatic portal area Lymph nodes around the place where the lymphatic vessels of the liver near the head and diaphragm converge and flow into the three hepatic veins of the inferior vena cava (second hepatic portal). Due to the deep location here, it is often difficult to detect enlarged lymph nodes. 3. Lymph node metastasis in the retroperitoneum Lymph node metastasis around the abdominal aorta and inferior vena cava and around the pancreas is manifested as round or oval hypoechoic foci, single or multiple.