Jaundice ascites is a common feature of liver cancer Liver cancer examination captures 4 important indicators
Liver cancer is one of the common malignant tumors in clinical practice, with a high mortality rate, and it is beneficial for everyone to understand its common symptoms and signs in a timely manner, which is more beneficial to the early detection and treatment of the disease, so what are the common signs of liver cancer?
1. Jaundice:
Diffuse liver cancer and cholangiocarcinoma are the most common in patients, and hepatocellular jaundice can be caused by extensive cancer infiltration; When the cancer invades the intrahepatic bile duct or the hilar lymphadenopathy and compresses the biliary tract, it can cause obstruction and jaundice; When tumor necrotic tissue and blood clots break off into the biliary tract, obstructive jaundice can occur when the biliary tract is blocked.
2. Hepatomegaly:
About 90% of patients with liver cancer will have this sign, which is mostly progressive, showing that the liver texture is hard, the surface and edges are irregular, often nodular shape, and a small number of tumors buried deep in the liver parenchyma have a smooth liver surface with or without obvious tenderness.
3. Splenomegaly:
Splenomegaly is common in the presence of concomitant splenomegalycirrhosisIn cases of portal hypertension, congestive splenomegaly can also occur when a cancer thrombus in the portal vein or splenic vein or when the cancer itself compresses the portal vein or splenic vein.
4. Ascites:
It is common in advanced liver cancer, and the incidence is mostly caused by chronic impaired liver function and decreased albumin synthesis or portal hypertension.
Ascites is generally pale yellow, and a few are bloody ascites, which are mostly caused by ruptured and bleeding of cancer nodules, and some bloody ascites can also be caused by tumor cell shedding.
5. Corresponding signs of metastasis:
Pathologic fractures may occur with bone metastases;
Pleural metastases can cause chest pain and bloody effusion;
lymphadenopathy may be present in lymphatic metastases;
paraplegia may occur with spinal cord metastases;
Neuropathic signs such as hemiplegia may occur in intracranial metastases, among other things.
6. Vascular bruit in the liver area:
Vascular bruits in the liver area are a special sign of liver cancer, which is mostly caused by enlarged tumors compressing the large blood vessels in the liver or the tumor itself is rich in blood vessels.
There are 4 important indicators in liver cancer screening
The main reason for the horror of cancer is that it is difficult to detect early, and at present, there are 4 indicators that can provide a valuable diagnosis for primary liver cancer after blood tests.
Primary liver cancer is one of the common malignant tumors in China, and its mortality rate ranks third among malignant tumors of the digestive system, second only to gastric cancer and esophageal cancer. Serological testing combined with imaging examination enables the diagnosis of liver cancer to be made in the subclinical stage (before symptoms appear), which significantly improves the long-term efficacy of liver cancer. At present, the following serum indicators are commonly used in hospitals to diagnose liver cancer (AFP), abnormal prothrombin (AP), γ-glutamyl transferase isoenzyme II (GGT2) and serum fucosidase (AFU).
4 important indicators of liver cancer screening
Alpha-fetoprotein (AFP)
Alpha-fetoprotein is an embryonic-specific alpha globulin discovered in fetal serum in 1956 and measured in serum from liver cancer patients in 1964.
Reference values:
Pathological significance: Under normal circumstances, the alpha-fetoprotein present in the early embryonic serum disappears rapidly after birth, and if it is reproduced in adult serum, it indicates the possibility of liver cancer.
In addition, in gonadal embryoma and a small number of metastatic tumors such as gastric cancer, as well as in pregnant women, hepatitis,cirrhosisSerum alpha-fetoprotein may be false-positive, but the elevation is not as pronounced as in liver cancer.Alpha-fetoprotein has been widely used in the screening, diagnosis, treatment effect, and prediction of recurrence of hepatocellular carcinoma. Positive results in the census can be 8~11 months earlier than the onset of symptoms. The positive rate of alpha-fetoprotein in patients with hepatocellular carcinoma is 70%~90%.
Diagnostic criteria: Alpha-fetoprotein > 500 micrograms/liter (micrograms/L) for 1 month, or 200 micrograms/liter (micrograms/L) for 2 months > without evidence of active liver disease, and excluding pregnancy and gonadal embryotuma, should raise suspicion of liver cancer. Alpha-fetoprotein concentrations are usually associated with tumor size, but they vary widely from person to person.
20%~45% of active chronic hepatitis andcirrhosisIn patients, alpha-fetoprotein is positive at low concentrations, generally no more than 200 micrograms/liter (μg/L), and serum alanine aminotransferase is often significantly increased, and alpha-fetoprotein is increased at the same time, and decreases with the improvement of the condition and the decrease of serum alanine aminotransferase within 1~2 months. However, if a low alpha-fetoprotein concentration persists for 2 months or more, and serum alanine aminotransferase is normal, a high index of suspicion for subclinical liver cancer should be raised.
The clinical value of alpha-fetoprotein in hepatocellular carcinoma can be summarized as follows:
1. It is a diagnostic method second only to pathological examination;
2. It is one of the best early diagnosis methods at present, which can be diagnosed 8~11 months before the appearance of clinical symptoms;
3. It is a sensitive index that reflects the changes in the condition and the treatment effect;
4. It is helpful for the detection of subclinical, recurrent and metastatic liver cancer.
Abnormal prothrombin (AP)
Abnormal prothrombin is also called γ-carboxyprothrombin.
Reference values:
Clinical significance: The positive rate of abnormal serum prothrombin in patients with liver cancer was 69.4%. Most data show that abnormal prothrombin has a high specificity for primary liver cancer, while only a few are positive for benign liver disease and metastatic liver cancer, so it has early diagnostic value for subclinical liver cancer.
γ-Glutamyl transferase isoenzyme II. (GGT2)
The positive rate and specificity of γ-glutamyl transpeptidase isoenzyme II for the diagnosis of primary and metastatic liver cancer can reach 90%, and the positive rate of patients with non-cancerous liver disease and extrahepatic disease is less than 5%. γ-glutamyl transpeptidase isoenzyme II is not associated with alpha-fetoprotein concentration, and the positive rate of γ-glutamyl transpeptidase isoenzyme II is also higher in patients with low alpha-fetoprotein concentrations and false-negative liver cancer.
serum fucosidase (AFU)
Reference value: 3.5~10.3 units/liter (U/L).
It has been reported in China that the positive rate of serum fucosidase in the diagnosis of primary liver cancer is 70%~80%, and the positive index is not related to alpha-fetoprotein concentration and tumor size. The positive rates of serum fucosidase in patients with alpha-fetoprotein-negative liver cancer and small liver cancer were 76.1% and 70.8%, respectively. It is negative for metastatic liver cancer and benign liver tumors, butcirrhosis, patients with chronic hepatitis have a higher false positive rate.
Alpha-fetoprotein, γ-glutamyl transpeptidase isoenzyme II., and abnormal prothrombin have positive diagnostic value for liver cancer, and also have early diagnostic significance in the general examination. The combination of three tests can greatly improve the diagnostic accuracy. Serum fucosidase has a certain diagnostic value for liver cancer, but the specificity is not high, and if it is combined with alpha-fetoprotein, it can be used as an auxiliary diagnosis for patients with alpha-fetoprotein-negative liver cancer.