In China, primary liver cancer is one of the most common malignant tumors, and its incidence has been gradually increasing in recent years. According to epidemiological surveys and studies, the four major factors causing primary liver cancer in China are: 1 hepatitis B virus and hepatitis C virus; 2 aflatoxin contaminated food; 3 drinking water contamination; 4 alcohol consumption and smoking. Primary hepatocellular carcinoma has an insidious onset and usually has no clinical symptoms in the early stage, or only signs and symptoms of liver disease. Once typical clinical manifestations, such as pain in liver area, wasting, jaundice, etc., appear, it is usually in the middle and late stage. Therefore, only 10-15% of patients with primary liver cancer have the chance to undergo radical surgery. The overall prognosis of patients with primary liver cancer is poor. Studies have shown that more than 80% of human cancers are caused by social and environmental factors and that cancer can be avoided and prevented.
People with high incidence of liver cancer.
1. People over 40 years old, surface antigen (HBsAg) positive and those with a history of chronic hepatitis C are all at high risk for liver cancer. 80-90% of patients with primary liver cancer are combined with hepatitis B. Hepatitis B is easily transformed into cirrhosis and then into liver cancer. The incidence rate is 3-4 times higher in men than in women. For people with high incidence of liver cancer, fetoprotein test and ultrasound should be performed every 3-6 months, which is an economic, easy and effective method for early detection of liver cancer.
2. People who drink alcohol for a long time: alcohol is harmful to human body. The gastric mucosa in the stomach has a protective effect on the body. Alcohol can digest the gastric mucosa away, the cells of the stomach are injured, and the toxic substances in food are easily absorbed by the stomach. This makes it easy to cause alcoholic or toxic substance-induced hepatitis, which reduces the immune function of the liver and the immune function of the whole body, and impairs the detoxification function of the liver. This is why people who drink alcohol have poor detoxification functions and are prone to alcoholic cirrhosis. Some of these cirrhosis will turn into liver cancer.
3. The increase of fatty liver in children and adults has also become a potential risk group. Fatty liver can also turn into cirrhosis and then from cirrhosis to liver cancer.
Three levels of prevention of liver cancer
Primary prevention: According to a large number of epidemiological surveys in China, the seven-word policy of “change water, prevent mold, prevent hepatitis” or “control water, control food, prevent hepatitis” proposed in the 1970s has not only been effective but also become the primary prevention of liver cancer in China. In the past one or two decades, some of the patients have been treated with the same treatment. In the past one or two decades, the incidence rate and mortality rate of liver cancer have dropped significantly in some areas with high incidence of liver cancer by adopting primary prevention measures.
Secondary prevention can be summarized as “early detection, early diagnosis and early treatment”. Two early preventions can improve the efficacy: two early preventions refer to early prevention and early diagnosis of liver cancer. Clinical practice proves that the treatment effect of small liver cancer with diameter less than 3 cm is very different from that of middle and late stage liver cancer. Middle and late stage liver cancer, often accompanied with metastasis inside and outside the liver, cannot be removed surgically, and interventional embolization and drug treatment are hardly effective. However, for small hepatocellular carcinoma diagnosed in early stage, surgical resection, embolization, ablation and other treatment methods have good results. Early prevention is to avoid hepatitis transmission, avoid eating moldy food, avoid liver damage such as alcohol and drugs, and maximize the prevention or mitigation of liver fibrosis progression, etc.
Tertiary prevention is clinically active treatment. Four types of treatment measures: surgical treatment is highly invasive and costly. In addition, lobectomy is affected by factors such as liver function status, liver cancer site and medical technology conditions, and is not an ideal choice for patients with cirrhosis. Local treatment, radiofrequency treatment for small hepatocellular carcinoma, which is less traumatic, less damaging to liver and can be used repeatedly, has become the preferred treatment for small hepatocellular carcinoma, and interventional embolization is also an option. There are more middle and late stage liver cancers when patients are seen, and interventional embolization therapy has become the preferred method, especially those liver tumors with good arterial blood supply, including giant tumors, which have remarkable efficacy. Extracorporeal tumor high-frequency thermotherapy with hepatic artery cannulation embolization chemotherapy can exponentially increase the concentration of chemotherapeutic drugs at the tumor site, enhance the cytotoxicity of chemotherapeutic drugs, significantly improve the cure rate, and have the effects of improving the immunity of patients’ organism, relieving pain, increasing the efficacy, and preventing recurrence and metastasis. New technology such as immunotherapy system has the effect of improving leukocytes and platelets in patients after radiotherapy and improving immunity with remarkable efficacy, which has been used clinically in our hospital. Drug therapy includes chemotherapy, immunotherapy, Chinese medicine therapy, gene therapy, etc. Drug therapy is an adjuvant treatment and its efficacy is limited when applied alone.
Three-level census management of liver cancer.
According to the risk level of liver cancer, the groups of people who are prone to liver cancer are generally divided into three categories, and three-level screening means different examinations are conducted according to the three categories.
The first group is the high-risk group, such as patients who have developed cirrhosis due to chronic viral hepatitis (hepatitis B or C). The general high-risk group will have relevant tests (liver function, alpha-fetoprotein and ultrasound) every 3 months.
The second group is the moderate risk group, such as patients with chronic viral hepatitis but without a family history of cirrhosis and liver cancer, with the moderate risk group having at least 1 test every 6 months
The third category is the low-risk group, such as patients with non-viral causes of cirrhosis. The low-risk group should have relevant examinations once every 1 year.
Once a suspicious case is detected, further CT, MRI or arteriography should be performed until liver cancer is ruled out.
Five preventive measures for liver cancer prevention
At present, the most important measure to prevent primary liver cancer is hepatitis B vaccination to prevent the occurrence of hepatitis B. On the other hand, hepatitis B virus carriers currently account for 1/10 of the total population in China. Active census can detect early liver cancer patients, achieve early diagnosis and early treatment, and make it possible for more liver cancer patients to have long-term survival. To prevent liver cancer, we should start from the following points.
1. To prevent viral hepatitis, research results show that hepatitis B vaccination can significantly reduce the incidence of hepatocellular carcinoma. The occurrence of hepatocellular carcinoma is closely related to hepatitis virus infection, and the correlation with hepatitis B virus infection is particularly obvious. The correlation between hepatocellular carcinoma and hepatitis B virus is stronger in children than in adults – the rate of positive serum hepatitis B surface antigen in children with hepatocellular carcinoma is nearly 100%, while the rate of positive serum hepatitis B surface antigen in adults with hepatocellular carcinoma is 70% to 80%. Therefore, the incidence of hepatocellular carcinoma in children can be used as an indicator of the effectiveness of hepatitis B vaccine programs in reducing hepatocellular carcinoma. The use of hepatitis vaccine to prevent hepatitis and thus liver cancer has become one of the most promising ways to prevent liver cancer, not only for children born with hepatitis B vaccine, but also for adults who have not been vaccinated against hepatitis B and who have not had hepatitis. However, it is estimated that it will take decades to see results. In addition to hepatitis B vaccination, attention should also be paid to the control of other transmission routes, such as diet, surgery, blood transfusion, injection, acupuncture and haircut, etc. Among them, preventing the route of acupuncture and blood transfusion can effectively prevent the occurrence of hepatitis C and thus liver cancer. One of the causes of liver cancer is caused by virus. To prevent hepatitis virus, we also need to start from dietary hygiene and living habits. It is important to wash hands regularly and to share utensils for meals. It is worth noting that people with hepatitis should not be chefs.
2, can not eat moldy food, this kind of food contains aflatoxin, easy to cause liver cancer. There is also free rice, Professor Wang Jianzhang said, “I think it is not necessarily good, in a plastic bag if you encounter high temperature, high temperature in the grain, moisture greater than 16%, it will mold. Moldy food must be dried, for example: corn, peanuts, peanut oil, peanut butter, etc. is easy to moldy food, these foods should be kept with care.”
3, drinking water hygiene do not pollute, there are chemicals drinking water is easy to let people grow cancer. Tap water is not necessarily clean, there are water tanks on the roofs of high-rise buildings above 5 floors, the tanks should be cleaned, preferably for secondary disinfection, the tank should also use chemicals that do not contaminate the water.
4, proper selenium supplementation. For low selenium people use selenium-rich yeast, selenium polysaccharide, selenium-rich salt to supplement selenium and improve blood selenium levels.
5, reduce nitrosamine intake as well as quit smoking, quit drinking. Drinking wine, beer and a small amount of wine can activate blood circulation, which is actually not the case, and drinking is easy to cause or alcoholic liver disease.
Tips to prevent liver cancer life.
1.Hepatitis B vaccination and go to a specialized hospital or epidemic prevention station to test the actual effect of vaccination
2. Preserve food at home to prevent mold and mildew. Resolutely do not eat aflatoxin-contaminated rice, flour, corn, soybeans, peanuts, etc.
3, do not eat or eat less food containing oxynitramine substances, such as sauerkraut, pickled vegetables, salted fish, sausages, etc.
4, quit drinking, alcoholism and other bad habits, do not drink strong wine, poor quality wine, to prevent the destruction of liver cells by alcohol, resulting in the operation of the liver and chronic liver poisoning.
5, pay attention to dietary hygiene to prevent the occurrence of viral hepatitis. Once suffering from viral hepatitis, should be actively treated, pay attention to rest, early recovery.