"I must be mistaken, I only checked liver function three months ago, how can it be that it is now advanced liver cancer?" Mr. Ma looked shocked with the examination report and told the doctor about his doubts.
Three months ago, Mr. Ma did an induction physical examination for a new company because of job hopping, and his liver function was completely normal. After three months, Mr. Ma went to the hospital again for physical examination because of abdominal pain, checked alpha-fetoprotein, and did a series of tests such as ultrasound, CT, magnetic resonance imaging, etc., and was diagnosed with advanced liver cancer.
Looking at the test results, Mr. Ma had some doubts, although he was a hepatitis B carrier, the liver function test three months ago was very normal, and how he had now developed to the advanced stage of liver cancer.
"Liver function is an important measure of liver health, but normal liver function does not necessarily mean that the liver is healthy," the doctor explains.
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The physical examination report often has a liver function project, but for people who lack medical knowledge, the physical examination report held in the hand is like a book of heaven, and the arrows are dizzy, and some patients who have a little understanding will delay the disease due to their own mistakes. Liver function, as the name suggests, is to check the various functions of the liver, which includes the liver's metabolism, synthetic capacity, damage, etc., which can help people understand the health of the liver to a large extent.
1. 2 indicators to understand the liver cell damage
There are two important indicators of reaction to hepatocyte damage, namely: alanine aminotransferase (ALT), also known as alanine aminotransferase and aspartate aminotransferase (AST), also known as glutamate aminotransferase. Changes in aminotransferase levels simply indicate whether liver cells are damaged and do not necessarily indicate more problems with the liver. Generally speaking, the rise of these two values will have two fundamental causes: pathological and physiological.
Pathological causes: myocarditis, acute pancreatitis, acute and chronic liver disease, biliary tract infection, cholelithiasis and other acute and chronic diseases.
Physiological causes: including pregnancy, staying up late, fatigue, drinking alcohol, strenuous exercise, colds, and even emotional factors.
During the examination process, a single increase in the value of transaminases cannot confirm any disease, but can only be used as a signal, and the doctor will continue to check one by one through the relevant detection of viral hepatitis, abdominal ultrasound and other means.
2. 3 indicators to understand the metabolic capacity of the liver
The three indicators that reflect the metabolic capacity of the liver mainly include total bilirubin, direct bilirubin and total bile acids. When there is damage to liver cells or obstruction inside and outside the liver, bile acids will appear metabolic abnormalities, total bile acids will be elevated, and hepatitis, cirrhosis, liver cancer and other diseases often cause obvious changes in total bile acids.
3. 2 indicators reflect the synthetic capacity of the liver
Two indicators, such as total protein and albumin, reflect the liver's ability to synthesize. When the liver is substantially damaged, such as cirrhosis, liver cancer, chronic hepatitis and other diseases, the function of hepatocyte synthesis proteins will be impaired, protein will be reduced, serum protein will be reduced, and the amount of albumin will also be reduced.
<h1 class="pgc-h-arrow-right" data-track="86" > second, normal liver function does not mean that the liver is normal</h1>
Liver function test as a resident item in the physical examination, many people will find that their liver function is normal during the physical examination, but it is not long before they have a serious illness, then the question comes, why is there no sign when the liver function test is taken?
The liver is a very tolerable organ
The liver because of the special "pain tolerance ability" by doctors jokingly called "dumb organs", because there is no nerve distribution inside and outside the liver, so liver damage patients are often not felt, and scientific research found that the liver even if only one-third can work normally, the human body will not have obvious metabolic abnormalities, because of this, many liver cancer patients find cancer, are because the liver tumor expanded and oppressed the surrounding tissues to feel abnormal.
Liver function tests can respond well to healthy people, but for patients with a history of liver disease in the past, the test results are not a criterion, or a single liver function test can only reflect limited values, and cannot reflect comprehensive results. This is especially true for liver cancer patients, and more effective testing methods are what everyone expects.
<h1 class="pgc-h-arrow-right" data-track="87" >3. What test is preferred for screening liver cancer? </h1>
Advances in medical technology have given patients more ways to screen for liver cancer, and liver cancer screening can be roughly divided into two categories, namely serum marker detection and imaging testing. Among them, serum markers can be divided into two ways: serum alpha-fetoprotein detection and hepatitis virus detection. Imaging examination is mainly based on ultrasound technology and magnetic resonance imaging instrument (MRI), and CT examination and hepatic angiography are also important methods. For screening for liver cancer in the general population, alpha-fetoprotein testing and ultrasound should be preferred.
1. Alpha-fetoprotein
The use of serum alpha-fetoprotein detection (AFP) is mainly to determine whether the patient has tumor markers, using radioimmunoassay detection, if the serum AFP continues to ≥ 400ug /L, it can be initially considered as liver cancer, alpha-fetoprotein test has a certain sensitivity, liver cancer patients with alpha-fetoprotein is not high and can not completely exclude liver cancer, so it is also necessary to use other testing methods.
2. Ultrasound
Ultrasonography is a non-invasive examination, simple operation, high sonogram resolution, this examination can reflect the size, morphology and location of the tumor, the accuracy rate is relatively high, and the advantage is that it can be repeatedly detected, and even multiple detections in a short period of time to determine the tumor growth rate, which plays a very large role in follow-up treatment.
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For healthy people, liver function tests can already meet the needs, but for high-risk groups, they need more accurate screening methods, so who in life needs to be screened?
The "Specifications for the Diagnosis and Treatment of Primary Liver Cancer (2019 Edition)" pointed out that in China, the high-risk groups of liver cancer mainly include the following groups, and it is recommended to conduct alpha-fetoprotein testing and ultrasonography at least every six months or one year.
1. Have hepatitis B virus and /or) hepatitis C virus infection;
2. Excessive alcohol consumption;
3. Non-alcoholic steatohepatitis;
4. Long-term consumption of food contaminated with aflatoxin;
5. Cirrhosis of the liver caused by various other causes;
6. People with a family history of liver cancer;
7. There are the above risk factors, and men > 40 years old are at greater risk.
After all, physical examination is a universal examination method in the current society, so it is impossible to prevent all diseases, and for high-risk groups of liver disease, it is gratifying to be in the current medical conditions, people have a better and more accurate way to screen the disease, as long as there is a positive and optimistic heart, the fight against the disease needs only to go to the hospital. #Healthy Heat Plan ##肿瘤科普排位赛 #
Resources:
[1] What are the preferred methods of liver cancer screening? 》. Health Guide.2020-10
[2] Why do I get liver cancer if my liver function test is normal? All the secrets of a liver checkup are here! 》. Health Times.2018-09-27
[3] "Seventy percent of liver cancer was diagnosed in the middle and advanced stages!" These 7 high-risk groups are screened every six months! 》. Health Times.2020-05-18
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