How to diagnose liver cancer
My loved one now at West China Hospital, doctors suspected to be liver cancer but has been hospitalized 20 days of the illness has not yet confirmed. Have found that hepatitis B has been more than a year, and we have ups and downs! More serious now go the Huaxi hospital in Chengdu other. Other indicators have been restored almost, but the AFP has always been 1210. to do CT, MRI, have not found any tumor, today had to do angiography, do not know what is the situation? Please answer everyone! Thank you, bless Ping'an good life!
Answer:
The diagnosis of liver cancer from the 30's "death of diagnosis" progress to the "clinical diagnosis" and 70's the "sub-clinical diagnosis." Different times of the progress and new diagnostic methods available .60 close contact with the end of the decade AFP Detected so that in the clinical diagnosis of liver cancer have a first leap; 80's electronic computer with the new technologies generated by ultrasound imaging, CT, MRI, such as the positioning of new diagnostic methods lead to liver cancer diagnosis came the second leap. first leap to make Diagnosis of liver cancer by the "period of clinical diagnosis" to "sub-clinical phase diagnosis" stage; second leap was to make sub-clinical phase to improve the diagnosis of liver cancer 1cm level, but also the clinical stage of liver cancer and more accurate diagnosis, intraoperative Application of ultrasound makes treatment has markedly improved. by the new technologies have brought about the concept of updating, "sub-clinical diagnosis of" concept has been completely updated over the past 100 years the concept of liver cancer diagnosis.
(1) liver cancer markers and laboratory tests:
On serum markers of liver cancer has been a large number of research, no less than as many as several dozen. Mainly have: alpha-fetoprotein (AFP) and its variants; various serum enzymes, such as GGT and its isoenzymes, ALD-A , AFU, AAT, ALP-, 5'-NPD-V, PyK, GST, etc.; other markers such as DCP, ferritin and acidic proteins, such as iron. But so far, in a variety of markers of liver cancer in no more than AFP, particularly in terms of early diagnosis, AFP has about 20 years to verify. However, because our country has 30 percent of liver cancer were 40 percent negative in the case of AFP, for which other markers of AFP-negative hepatocellular carcinoma still has its application value.
(2) Diagnostic Imaging
Ultrasound Diagnosis (Ultrasonography, US): the most common liver cancer diagnosed in the most effective way. Is a non-invasive positioning, relatively inexpensive, reusable, non-radioactive damage is highly sensitive. But difficult to detect existence of blind spots, by other the context of the impact of liver disease, but also by the operator anatomical knowledge, and careful inspection and operation of the impact or not. intraoperative ultrasound imaging
X-ray computer tomography (CT): hepatocellular carcinoma diagnosis of conventional projects. Its diagnostic value for specific lesion location, number, size and its relationship with important blood vessels; prompted lesions character; help radiotherapy positioning; have help to understand the surrounding liver tissues have foci is.
Magnetic resonance imaging (MRI): comparison with CT, which is characterized by being able to obtain cross-sectional, coronal and sagittal images; to differentiate between soft tissue better than CT; no radiation damage; of benign and malignant intrahepatic space-occupying , in particular with the identification of potential hemangioma is superior to CT. In addition, MRI can show the need to enhance the portal vein and hepatic vein branches.
Hepatic arteriography: Since the founding in 1953 by Seldinger percutaneous femoral artery cannulation own way since visceral angiography, selective or super-selective hepatic arteriography of liver cancer has become an important means of diagnosis.
Radionuclide imaging: radionuclide imaging at 60 and 70 during the positioning once the diagnosis of liver cancer are important means. However, because ultrasound, CT, MRI, etc. The advent of imaging, radionuclide imaging of small lesions in the show has been behind the former. in recent years because of single photon emission computed tomography (SPECT) applications, and application of monoclonal antibodies for imaging radioimmunoassay, and its importance once again be taken seriously.
(3) laparoscopy and liver puncture
Laparoscopic diagnosis of liver cancer have been used for many years and in recent years because of tumor markers and imaging technology, laparoscopy has become less. But diagnosis unclear, especially liver cancer are less likely to object, there is still a certain value.
(4) have symptoms of liver cancer and liver cancer diagnosis
As follows:
from the high incidence of liver cancer, middle-aged men than women, have a family history of liver cancer;
have hepatitis or cirrhosis background or evidence;
liver pain, epigastric mass,ɲ, weakness, weight loss, unexplained fever, diarrhea or right shoulder pain, liver, and nodular flu or right diaphragm elevation;
a small number of cancer nodules in the breakdown of acute abdomen, distant metastasis as the first symptom;
late emergence of jaundice, ascites, cachexia;
portal vein tumor thrombus oftenpain, abdominal distension, etc.;
without obvious abnormal SGPT increased AFP Tatsu 500g / L or more;
right phrenic activity limitation limitations uplift;
ultrasound imaging that has substantial mass halo;
CT showing real footprint, non-filled contrast agent injection;
hepatic arteriography showed tumor vessels and tumor staining;
99mTc-PMT scans were positive for hepatocellular carcinoma or hepatic adenoma.
(5) sub-clinical liver and small hepatocellular carcinoma diagnosis
Of sub-clinical liver cancer (ie, asymptomatic body disease) and small hepatocellular carcinoma (diameter less than 5cm are) mainly for the diagnosis of AFP and ultrasound diagnostic imaging such as positioning of the joint analysis.
