The incidence of hepatocellular carcinoma is the most common malignant tumor in the liver, and there is also cholangio carcinoma from the bile duct epithelium, the incidence of which is about 12 to 20:1. The general pathology of primary hepatocellular carcinoma can be divided into three types: nodular type is the most common, mostly accompanied by severe hepatic sclerosis; followed by giant type, mostly solitary; diffuse type is the least common and has the worst prognosis. Hepatocellular carcinoma has a tendency to invade the vascular growth, especially the portal vein, followed by the hepatic vein. In recent years, there are reports of “fibrolamellar hepatocellular carcinoma” (fibrolamellar HCC), which has slower growth, late metastasis, suitable for surgical treatment and has a better prognosis. Diagnosis Primary hepatocellular carcinoma lacks typical symptoms in the early stage, and the digestive symptoms such as hepatomegaly, pain in liver area and weakness and abdominal distension are not significantly different from cirrhosis and hepatitis. Once typical symptoms appear, treatment opportunities are often lost. Usually, the occurrence of hepatocellular carcinoma is indicated by the appearance of paraneoplastic syndrome such as erythrocytosis, hypercholesterolemia, abnormal blood sugar, mastocytosis and hypercalcemia. In addition, the occurrence of liver cancer should also be alerted when the symptoms of liver disease are significantly aggravated and the liver function is significantly deteriorated. The following tests should be performed for history of liver disease, unexplained wasting and pain in liver area: (a) AFP measurement: 60% to 80% of hepatocellular carcinoma is positive. If germinal gland embryonal tumor, active liver disease and pregnancy can be excluded, AFP quantification >500ng/ml for more than one month can be diagnosed as hepatocellular carcinoma. In the case of small hepatocellular carcinoma, the rate of AFP positivity is less than 20%. (b) Serum enzymatic examination: 50% of patients with hepatocellular carcinoma have elevated α-glutamyl transpeptidase, higher than normal lactate dehydrogenase isoenzyme (LDH 5), and elevated alkaline phosphatase. (c) B-mode ultrasonography: it can show the lesion site, size, relationship with bile duct and blood vessels and the presence of tumor embolus, and the diameter can be detected.