This is an automatically translated article.
The article is professionally consulted by Master, Doctor Nguyen Thanh Nam - Radiologist - Department of Diagnostic Imaging - Vinmec Danang International General Hospital. The doctor has over 10 years of experience in the field of Diagnostic Imaging.Primary hepatocellular carcinoma (HCC) is the most common cancer in both men and women. Early diagnosis is important for effective treatment. Diagnostic methods for HCC include blood tests and imaging studies.
1. An overview of liver cancer
Liver cancer includes primary liver cancer (cancer arising from liver cells or bile ducts) and secondary liver cancer (caused by cancer metastasis from another organ to the liver). In Vietnam, liver cancer is the third most common cancer after lung cancer and stomach cancer. In recent years, on average, Vietnam has over 10,000 new cases of liver cancer each year and becomes the country with the highest rate of liver cancer in the world.Risk factors for primary hepatocellular carcinoma: hepatitis B, C virus infection; cirrhosis, exposure to toxins that cause hepatocellular necrosis (aflatoxin molds from moldy grains and toxins such as dioxins, carbon tetrachloride, nitrosamines,...).
The average survival rate of liver cancer patients within 5 years after diagnosis is about 9%. If detected and treated in the early stages, about 19% of patients have the ability to live more than 5 years. The 5-year survival prognosis for patients with stage 2 liver cancer drops to about 6.5%. By the end stage, the 5-year survival rate of liver cancer patients is only about 3.5%.
Tỷ lệ sống của bệnh nhân ung thư gan không cao
2. Methods of diagnosing liver cancer
Some of the methods that are highly effective in diagnosing liver cancer are:2.1 Liver cancer marker tests Immunoassays
Alpha - Fetoprotein (AFP) test : AFP is a glycoprotein normally present only in the cytoplasmic phase. pregnant. In patients with primary liver cancer, the rate of AFP positivity ranges from 60 to 90%. For secondary liver cancer, this test is negative. When AFP quantified above 20 ng/ml was considered positive. If the AFP index is above 400 ng/ml, it has a definitive diagnosis of hepatocellular carcinoma. In addition, the AFP test is also used to monitor and evaluate the results of liver cancer treatment.
Xét nghiệm AFP chẩn đoán ung thư gan
Patients with liver cancer often have the following indicators:
Slightly decreased red blood cells, decreased hemoglobin. The white blood cells and white blood cell formula are usually reduced Protein, A/G ratio < l. Blood bilirubin may increase. Transaminases are moderately elevated. Low blood glucose due to decreased synthesis and storage of glycogen or malignant liver tumors containing insulin analogs. Liver arginase decreased < 40 units. LDH (lactico dehydrogenase): LDH5/LDH1 ratio > l. 2.2 Diagnostic imaging Ultrasound: is the first technique in diagnosing liver cancer, widely applied because of its low cost, simple implementation, no side effects and high diagnostic accuracy rate. can detect liver tumors over 1cm in size). Ultrasound shows the location and size of the tumor. In addition, this diagnostic method also helps detect comorbidities such as cirrhosis, portal hypertension. At the same time, ultrasound also helps guide measures for liver cancer treatment such as liver resection, percutaneous tumor killing, etc. However, ultrasound does not reveal the nature of the tumor. Computed tomography (CT scanner): especially liver kinetic computed tomography (multi-stage liver) has high diagnostic value, sensitivity up to 94% for tumors >1cm. Selective hepatic angiography: allows the doctor to see the arteries in the liver that are enlarged by the tumor and the specific image of liver cancer. Currently, using digital angiography to erase the background helps doctors accurately observe the tumor status in the liver. This method has an accuracy of up to 90% for tumors less than 3cm. Magnetic resonance imaging (MRI) of the liver: has a high diagnostic accuracy (diagnosis accuracy rate up to 97.5% with tumors over 2cm in diameter) and helps to detect invasive venous lesions in the liver. Liver biopsy: for histopathological examination, especially in cases of suspected cancer with other lesions. Liver biopsy under ultrasound guidance is convenient, has few complications and has a high diagnostic accuracy rate. Doctors can biopsy the patient's liver through laparoscopy or under the guidance of computed tomography. The accuracy rate of this method is over 90%. Other diagnostic methods: chest X-ray (detecting lung metastases), portal vein scan, laparoscopy,... Liver cancer progresses silently, so most patients are often detected late. , the survival rate is not high. Therefore, people with risk factors such as having hepatitis B, C, cirrhosis, drinking a lot of alcohol and having a family member with liver cancer should regularly check for early detection.
Người có nguy cơ cao mắc ung thư gan nên thực hiện tầm soát ung thư định kỳ
When registering for the package of screening and early detection of liver cancer, customers will be examined and consulted with an Oncologist; total analysis of peripheral blood cells; assess liver function through tests of ALT, AST, GGT, total bilirubin; screening for hepatitis B and C virus infection through HBsAg, HCV Ab automatic immunoassay; Screening for liver cancer through quantitative AFP test and abdominal ultrasound.
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