Prevention and interventional treatment of primary liver cancer

Primary liver cancer is one of the most common malignant tumors in the world. Compared with other malignant tumors, it has many characteristics such as difficult to detect, difficult to diagnose, difficult to treat, fast progress and poor prognosis. Therefore, prevention, early diagnosis and interventional treatment of liver cancer are of great importance. According to statistics, about 70-80% of liver cancer patients are related to hepatitis B, and about 15-20% are related to hepatitis C and D. Another 5% of liver cancer patients may be related to alcoholism, parasitic infection, diet and other factors. Therefore, regular checkups are essential for the above-mentioned high-risk groups. The most effective way to detect liver cancer at an early stage is to test methemoglobin and liver ultrasound once every six months for people over 35 years old who are at high risk of hepatitis B surface antigen positivity, chronic hepatitis, cirrhosis of the liver for more than 5 years, and family history of liver cancer in three generations of immediate family members. We should treat chronic hepatitis seriously and use antiviral drugs in a standardized and reasonable way. For patients with chronic hepatitis B, interferon and nucleoside analogues can be used for antiviral treatment under the guidance of professional physicians, and a lot of research data show that they can effectively prevent the occurrence of hepatocellular carcinoma. For patients with hepatitis C, interferon and ribavirin are effective drugs to stop the chronicity of hepatitis and the malignant transformation to hepatocellular carcinoma. For the rest, the occurrence of hepatocellular carcinoma can be significantly prevented by abstaining from alcohol and improving dietary structure. Introduction of interventional treatment for hepatocellular carcinoma I. Transhepatic artery chemoembolization (TACE): That is, intravascular interventional treatment. The effectiveness of interventional treatment is determined by the characteristics of blood supply of liver cancer. Normally, the liver is supplied with blood by hepatic artery and portal vein, of which portal vein supply accounts for 75% to 80% and hepatic artery supply accounts for 20% to 25%. The blood supply of hepatocellular carcinoma is exactly the opposite, more than 90%-95% of hepatic carcinoma is supplied by hepatic artery and very little by portal vein, which brings convenience for treatment. Through hepatic artery cannulation, drugs can directly enter liver cancer tissues to increase the local drug concentration and kill cancer cells. In addition, some embolic substances such as iodine oil and gelatin sponge are applied to embolize the blood supply artery of liver cancer to cut off its nutritional effect, and the tumor tissues will be necrosed, so as to achieve the purpose of treatment. New methods of liver cancer treatment – radiofrequency ablation and microwave ablation: that is, extravascular intervention. Both radiofrequency ablation and microwave ablation for liver cancer can destroy the tumor at the primary site without taking it out of the body, so it is called in situ tumor inactivation treatment. There is no significant difference in survival and recurrence rates between radiofrequency ablation and surgical treatment in a randomized controlled study of patients with small hepatocellular carcinoma, which can also achieve radical therapeutic effect, and the recent efficacy of stage Ia small hepatocellular carcinoma is still better than surgical resection. The specific methods of both treatments are similar, i.e., the electrode needle is punctured into the tumor under ultrasound guidance to generate high temperature in the local tissue of the lesion for the purpose of coagulation and inactivation of the tumor. Radiofrequency and microwave ablation treatments can not only directly coagulate and necroticize tumor cells and completely inactivate liver cancer tissues in situ, but also improve the number of immune cells and their anti-tumor function in tumor local and peripheral blood. Compared with traditional treatments, RF and microwave ablation therapy has the advantages of less trauma, safe and reliable, stable coagulation necrosis range, exact efficacy and low recurrence rate.