Liver cancer is one of the common malignant tumors in China, and its mortality rate ranks second among malignant tumors, so what are the clinical manifestations of liver cancer? Once symptoms appear, most of them are in the middle and late stages of the disease. The clinical manifestations of different stages of liver cancer are obviously different. The most characteristic clinical symptoms are liver pain, weakness, poor appetite and emaciation. Pain in liver area is the most common, intermittent and persistent, dull pain or swelling pain, which is caused by the rapid growth of cancer that tenses the liver envelope. If the tumor invades the diaphragm, the pain can be radiated to the right shoulder or right back. Tumor growing backward to the right can cause right back pain. Sudden occurrence of severe abdominal pain and peritoneal irritation sign indicates subperitoneal bleeding or rupture of cancer nodules into the abdominal cavity. 2. Gastrointestinal symptoms, loss of appetite, dyspepsia, nausea, vomiting and diarrhea, etc. are easily ignored because of lack of specificity. Ascites or portal vein cancer embolism may lead to abdominal distension and diarrhea. 3.Weakness, emaciation, general weakness, and a few patients in the late stage may show cachexia. 4.Fever, generally low fever, occasionally above 39℃, continuous or afternoon low fever or chills type high fever. The fever is related to the absorption of necrotic products of cancer tumor. Biliary tract infection can be complicated by cancer compression or invasion of bile duct. 5. Metastatic foci symptoms, there are corresponding symptoms where the tumor metastasizes, which sometimes become the first symptoms of liver cancer. For example, metastasis to lung may cause coughing and hemoptysis, and pleural metastasis may cause chest pain and bloody pleural fluid. Embolism of pulmonary artery by cancer embolism can cause pulmonary infarction, which can lead to severe respiratory distress and chest pain suddenly. The obstruction of inferior vena cava by cancer embolus may lead to severe edema of lower limbs and even decrease of blood pressure; the obstruction of hepatic vein may lead to Budd-Chiari syndrome and edema of lower limbs. Metastasis to bone may cause local pain or pathological fracture. Metastasis to the spine or compression of spinal nerves may cause local pain and paraplegia. Intracranial metastasis may cause localized symptoms and signs, and intracranial hypertension may lead to brain herniation and sudden death. Other systemic symptoms, endocrine or metabolic syndromes caused by metabolic abnormalities of the cancer itself or various effects of cancer tissues on the organism are called concomitant cancer syndrome, which sometimes may precede the symptoms of liver cancer itself. The common symptoms include: (1) spontaneous hypoglycemia, which can occur in 10-30% of patients because hepatocytes can ectopically secrete insulin or insulin-like substances; or the tumor can inhibit insulinase or secrete an islet beta-cell stimulating factor or excessive glycogen storage; or it can be caused by excessive consumption of glucose by liver cancer tissues. This disease can lead to coma, shock or even death in serious cases. Proper judgment and timely symptomatic treatment can save the patient from death. (2) Erythrocytosis, which can occur in 2-10% of patients, may be caused by an increase in circulating erythropoietin. (3) Other rare ones include hyperlipidemia, hypercalcemia, carcinoid syndrome, gonadotropin secretion syndrome, dermal porphyria and abnormal fibrinogenemia, which may be related to abnormal protein synthesis, ectopic endocrine and porphyrin metabolism disorders in hepatocellular carcinoma tissue. Signs 1. Hepatomegaly Progressive hepatomegaly is one of the most common characteristic signs. The liver is hard, with irregular surface and edges, often nodular, while in a few cases, the surface of the liver is smooth with or without obvious pressure pain. Carcinoma on the diaphragmatic surface of the right lobe of the liver may cause significant elevation of the right diaphragm. 2.Splenomegaly is mostly seen in cases of combined cirrhosis and portal hypertension. Cancer thrombus in portal vein or splenic vein or liver cancer compressing portal vein or splenic vein can also cause congestive splenomegaly. Ascites is straw yellow or bloody, mostly caused by combined cirrhosis, portal hypertension, portal vein or hepatic vein cancer embolism. The local rupture and erosion of the cancer infiltrating into the liver surface or the coagulation dysfunction of the liver may cause bloody ascites. 4.Jaundice When the cancer infiltrates widely, it can cause hepatocellular jaundice; when it invades the intrahepatic bile duct or the enlarged lymph nodes of the liver gate press the bile duct, it can cause obstruction jaundice. Sometimes tumor necrotic tissue and blood clots shed into the bile duct causing bile duct obstruction can cause obstructive jaundice. 5.Vascular murmur in the liver area is caused by the tumor pressing the large blood vessels in the liver or the tumor itself is rich in blood vessels. 6.Hepatic abrasive sounds can be heard occasionally on the surface of the liver area, which indicates that the liver envelope is invaded by the tumor. 7.The corresponding signs of metastasis may include enlarged supraclavicular lymph nodes, pleural lymph may show pleural effusion or hemothorax. Bone metastasis can be seen as the bone surface protrudes outward, and sometimes pathological fracture can appear. Spinal cord metastasis may show paraplegia if it compresses the spinal nerve, and intracranial metastasis may show neuropathic signs such as hemiplegia.