This is an automatically translated article.
The article was professionally consulted by Doctor Trinh Le Hong Minh - Radiologist - Radiology Department - Vinmec Central Park International General Hospital.Liver cancer is a dangerous disease and the leading cause of death for both men and women. The disease is often detected at a late stage, so the treatment is difficult and the prognosis is poor. Therefore, early detection of the disease is very important in the treatment, monitoring and prognosis of the disease.
1. Liver cancer overview
Liver cancer is a condition in which liver cells grow abnormally, causing changes in liver structure and function. Invasive cells and healthy cells and nearby organs. In addition, liver cancer is caused by the migration of abnormal cells from another organ. Liver cancer has two types including:
Primary liver cancer : To refer to the disease that occurs when the cells of the liver become abnormal, affecting liver function, can spread to other areas of the liver as well as organs outside the liver. Primary liver cancer includes 3 main types: hepatocellular carcinoma (which develops from hepatocytes is the most common), cholangiocarcinoma (which develops from intrahepatic cholangiocarcinoma). ) and hepatoblastoma. Secondary liver cancer is a disease in which a tumor occurs in the liver, but this tumor is caused by cancer cells in other parts of the body that have migrated to the liver. It can be a tumor in the stomach, gallbladder, colon, pancreas, breast, lung...
Ung thư gan ảnh hưởng nghiêm trọng đến sức khỏe người bệnh
2. Causes of liver cancer
The exact cause of liver cancer is still unclear. Some risk factors for liver cancer include:
Viral hepatitis: Viral hepatitis is an acute or chronic inflammation or necrosis of liver cells caused by a virus. The virus causes hepatitis, but there is an association between hepatitis B and C with cirrhosis and primary liver cancer. In Vietnam, 60% of hepatocellular carcinomas are related to hepatitis B and 25% are related to hepatitis C. Cirrhosis: Cirrhosis is a condition in which the liver is damaged leading to the formation of many scar tissue. caused by many pathogens. Liver cancer is common in cirrhotic patients, most of which are alcoholic cirrhosis. Using substances that are toxic to the liver: Regularly ingesting Aflatoxin molds from peanuts, moldy beans. Toxic substances, especially Agent Orange (dioxin), carbon tetrachloride, Azo colorants or nitrosamines cause liver cancer in vitro. Drinking a lot of alcohol and beer: Most of the toxins from alcohol are detoxified by the liver, if you regularly use alcohol, it can damage liver cells, leading to cirrhosis and liver cancer. Diet: Eat moldy, unhygienic, low-protein, high-fat, low-vitamin B1 diet.
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3. Signs of liver cancer
In the early stages, often the signs of liver cancer are not clear, patients may show signs such as: fatigue, loss of appetite, nausea, vomiting, fast fullness or bloating after eating, pain ie right rib area...
Later stages see symptoms such as:
Poor eating, anorexia, bloating, stools may have scum. Right lower quadrant pain is increasing. The patient can feel the mass in the liver. Jaundice, mucous membranes and eye conjunctiva are also yellow, there is a feeling of skin itching. This condition is caused by an increase in the amount of bilirubin in the blood. Passing discolored stools, dark urine. Abnormal bleeding such as bleeding gums in teeth, bleeding under the skin... Sudden weight loss, unknown cause. Swollen or distended abdomen due to ascites. Liver cancer often has obvious symptoms appearing at a late stage, so patients with previous liver disease should have regular health check-ups to detect the disease early.
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4. Ultrasound image of liver cancer
Ultrasound is a non-invasive imaging method, through ultrasound the doctor relies on some characteristics of the lesion to aim at early diagnosis of liver cancer and cirrhosis of the liver, hypertension. portal vein force.
The images of liver cancer lesions on ultrasound include:
4.1. Primary liver cancer
Primary liver cancer is a lesion with diverse shapes, specifically:
With primary cancer smaller than 3cm, it usually has a nodular shape, the border is not clear, this nodule can be hyperechoic or hypoechoic compared to with liver parenchyma, but mainly hypoechoic nodules. Vascular Doppler shows increased vascularization in the tumor, with the typical perfusion picture showing a small network of flow from around the mass into branches within the mass. For tumors over 3cm: Nodules may be encountered with well-defined nodules, irregular sound structure and surrounding hypoechoic border; Typical infiltrates by mass with unknown tumor boundaries, invasion of surrounding areas, portal vein invasion and compression of surrounding tissues; A diffuse form, see scattered nodules in the liver, small in size, this form is rare. Cholangiocarcinoma: Uncommon, on ultrasound, the tumor is usually large in size, clearly demarcated, with diverse acoustic structure, with calcified nodules in the center.
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4.2. Secondary cancer
The liver is the most common organ for metastatic tumors. Metastatic tumors are of variable size and shape.
Often seen many tumors of various sizes scattered on the liver, can be hyperechoic or hypoechoic, but often hypoechoic compared to the liver parenchyma, about 40% of tumors are seen with hypoechoic margins around, pulse doppler is seen metastatic tumor with little or no proliferative vascular signal. In general, metastatic lesions often show multifocal lesions, especially if the background of the patient has been diagnosed with cancer, it is more likely to be considered as liver metastases. Signs of portal vein thrombosis can be detected early by liver ultrasound, venous thrombosis of invasive tumors. In some cases, signs of cirrhosis can be seen such as: Rough, irregular liver parenchyma, irregular liver margins, change in liver size, portal hypertension... In addition, one can use Using tissue elastography, this is a new method used in recent years to diagnose cirrhosis and liver tumors with 90% accuracy compared to biopsies, helping to minimize liver biopsy condition. This method is based on the degree of elasticity of the tissue under compression to determine the pathological condition. From ultrasound elastography of the liver to determine the stiffness of the tissue, through the conversion to evaluate, it is reduced to 4 levels including score 4 as malignant tumor; score 2.3 is doubtful, other factors should be considered; score 1 is a benign lesion.
Liver cancer is a dangerous disease, early detection of the disease is essential to help treatment, prognosis, increase the cure rate and increase the patient's life expectancy. Ultrasound is a simple, easy, non-invasive, and highly accurate method to help guide the diagnosis of liver cancer. If there are any suspicious signs of the disease, the patient should be examined for early detection of the disease.
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