The onset of hepatocellular carcinoma is relatively insidious and there are usually no symptoms in the early stage. The incidence of typical symptoms of hepatocellular carcinoma is basically the same at home and abroad, and the first symptom is pain in the liver area, followed by epigastric mass. The first symptom is pain in the liver area, followed by epigastric mass, poor nasality, weakness, emaciation, fever of unknown origin, diarrhea, abdominal pain. Right shoulder pain, etc. Some patients also present with some complications of cirrhosis, such as black stool, vomiting blood. Jaundice, etc. A few patients are hospitalized due to the symptoms caused by metastases, and most of these symptoms are not specific. The following is an introduction to some common symptoms of liver cancer. 1. Pain in liver area Most of the patients with middle and late stage liver cancer have pain in liver area as the first symptom, and the incidence rate is over 50%. Pain in the liver area is usually located in the right rib area or under the raphe, and the nature of pain is intermittent or continuous hidden pain. Dull pain or stabbing pain, the patient may feel discomfort in the right upper abdomen for a period of time before the pain. The pain may be mild and severe or may be relieved by itself for a short period of time. The pain is mainly caused by the rapid enlargement of the tumor, which compresses the peritoneum of the liver and produces pulling pain, or it can also be caused by the necrotic material of the tumor irritating the peritoneum of the liver. In a few patients, the sudden onset of severe pain in the liver area spontaneously or after liver puncture is mostly due to the rupture and bleeding of cancer nodules located on the surface of the liver. If there are also signs of blood pressure drop and shock, and there is bloody fluid in the abdominal puncture, it means that the rupture and bleeding of cancer nodules are serious. In this case, emergency resuscitation is needed. If there is no accompanying symptom as mentioned above and the pain is more limited, it indicates that the bleeding is located under the liver peritoneum. Pain may vary according to the location of tumor growth. Tumor located in the left lobe often causes pain in the middle and upper abdomen; tumor located in the right lobe causes pain in the right quarter rib area; when tumor involves the transverse septum, pain radiates to the right shoulder or right back, which is easily mistaken for shoulder arthritis; when tumor is located in the posterior part of the right lobe, it sometimes causes lumbar pain; if tumor is located in the deep part of liver parenchyma, it seldom feels pain in general. 2. Gastrointestinal symptoms Decreased appetite, epigastric fullness after meals. Ambiguous gas, indigestion and nausea are common digestive tract symptoms of liver cancer, among which loss of appetite and abdominal distension are the most common. Diarrhea is also a common GI symptom of hepatocellular carcinoma, which has been reported both at home and abroad with high incidence and is easily mistaken for chronic enteritis. Portal hypertension and intestinal dysfunction caused by portal vein or hepatic vein thrombosis can lead to abdominal distension and increased stool frequency, and abdominal distension can also be caused by ascites. Gastrointestinal dysfunction can also lead to indigestion, ambiguous gas, nausea and other symptoms. 3.Fever A considerable number of liver cancer patients will have sweating and fever. Most of the fever is low to moderate fever, and a few patients may have high fever, above 39℃, which is usually not accompanied by chills. Most of the fever in liver cancer is cancer fever, which is caused by the release of pyrogen into the blood circulation after the necrosis of tumor tissue. It is sometimes not easy to distinguish it from cancer fever of liver cancer, and it can be determined only after combining with blood picture and observing the effectiveness of antibacterial treatment. 4. Lethargy and fatigue Patients with liver cancer often feel more fatigued than patients with other tumors, which is similar to patients with chronic hepatitis. The causes of weakness are unknown. It may be due to digestive disorders, lack of energy due to impaired nutrient absorption, or damaged liver cells and decreased liver function, which may cause metabolic disorders, inactivation of certain toxins in time, or release of toxic substances due to necrosis of liver cancer tissues. Wasting is also a common symptom of liver cancer patients, which is due to impaired liver function. It is caused by the decrease of digestion and absorption function. With the development of the disease, the degree of wasting can be aggravated, and in serious cases, cachexia can appear. 5. Bleeding tendency Patients with hepatocellular carcinoma often have bleeding tendency such as gum bleeding and subcutaneous bruises, which are mainly due to impaired liver function and abnormal blood clotting function, especially in patients with liver cancer combined with cirrhosis. Gastrointestinal bleeding is more common and is mainly due to varices in the esophagogastric fundus due to portal hypertension. In fact, gastrointestinal bleeding is also the most important cause of death in patients with hepatocellular carcinoma. Lower limb edema Patients with hepatocellular carcinoma with ascites often have lower limb edema, which may occur in the ankle in mild cases or spread to the whole lower limb in severe cases. In clinical practice, we have seen some patients with highly edematous lower limbs, and the water can ooze out from the skin of thighs. The main cause of lower extremity edema is the obstruction of venous return by ascites compression of lower extremity veins or cancer embolism. Mild edema can also be caused by low plasma albumin. 7.Acute abdomen The rupture of cancer nodules usually causes pain in the liver area and obvious pressure pain in the liver area during physical examination, which is a symptom of liver peritoneal irritation. After rupture of cancer nodules, some patients show acute abdominal pain with peritoneal irritation symptoms, which can be easily misdiagnosed as acute peritonitis. The abdominal pain caused by rupture of cancer nodules is usually accompanied by the manifestation of blood pressure drop or even shock, which is different from general acute peritonitis.