How much do you know about liver disease tests?
One of the main characteristics of liver disease is that most of the early symptoms are not obvious or are not typical, which can easily cause patients and family members to ignore the disease and delay it. I would like to introduce a typical case of delayed disease to you. For example: a colleague of mine. So how to detect liver disease, it is necessary to perform some liver disease tests to understand liver disease. Let’s find out what liver disease tests are available.
First, let’s give you a basic overview of the liver. The liver is the largest organ in the human body and is located in the middle of the abdomen, under the right diaphragm, in front of the gallbladder and in front of the right kidney, above the stomach. The liver is the largest digestive gland in the human digestive system, weighing on average 1.5 kg (about 1-2.5 kg) in adults, and is a reddish-brown, V-shaped organ. The liver is also the most complex metabolic organ in the body, carrying out thousands of biochemical reactions every day. Since the mid-20th century, several laboratory tests, called liver function tests, have been developed, but they also do not fully reflect the biochemical changes that occur in liver injury. Liver biochemical tests should be used instead of this name. There are currently more than a dozen liver biochemical tests available for clinical application.
So, what are the items that are normally included in our liver function tests?
There are several major categories.
The tests of serum enzymes in liver function, such as glutamic aminotransferase (ALT), glutamic oxaloacetic aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (γ-GT), etc., mainly ALT and AST, can indicate liver cell damage and its degree of damage; among them, ALT is the most specific, indicating that the liver has been damaged by a certain degree of inflammation. elevated GGT and ALP may be bile duct disease or alcoholic liver disease.
Decreased plasma albumin, prolonged prothrombin time (PT), and decreased PTA suggest diminished hepatic synthesis; most patients with cirrhosis show decreased albumin, but also patients with severe hepatitis, and patients with liver cancer. Of course, other diseases, such as nephrotic syndrome, can also cause a decrease in albumin. Similarly, a decrease in PTA reflects poor hepatic synthesis.
Bilirubin reflects hepatocyte necrosis or cholestasis. Jaundice in liver disease is indicative of a more serious condition.
Detection of abnormal hepatocyte proliferation, AFP, GGT isoenzyme. significantly elevated AFP suggests hepatocellular carcinoma. AFP can also be elevated in infants and children, and the specifics, to be analyzed.
In fact, there are fewer items included in a normal checkup, and if problems are found, further tests are needed.
Liver function test can give warning at the first time of liver lesion, when active and effective treatment is taken, the transformation of hepatitis to cirrhosis and liver cancer can be completely blocked. It is a key test to prevent cirrhosis and liver cancer.
What should I do if there is an abnormal liver function?
It means that at this time your liver is diseased, inflamed and damaged in some way. Further tests need to be performed. For example, testing for hepatitis B, testing for hepatitis C, testing for fatty liver, testing for self-exempt liver, etc.
Let’s start with the hepatitis B test. The main tests include hepatitis B two pairs of half, HBVDNA and so on. What is hepatitis B “two and a half”?
Hepatitis is a disease with a high incidence worldwide, with about 300 million people worldwide suffering from hepatitis. China is a high prevalence area for hepatitis, and the number of people with liver disease accounts for 100-200 million, mostly hepatitis B. In other words, every 10 people have a hepatitis patient, and the hepatitis virus may exist around you and me. When you suspect that you are infected with the hepatitis B virus, the first test that comes to mind is probably the hepatitis B “two-to-one” test. What exactly does a hepatitis B “half test” entail?
The test for hepatitis B patients is called the “Hepatitis B Virus Marker” and includes two antigens: surface antigen (HBsAg) and E antigen (HBeAg); and three antibodies: surface antibody (anti-HBs) and E antibody. -HBs), E antibodies (anti-HBe) and core antibodies (anti-HBc). The core antigen (HBcAg) corresponding to anti-HBc exists mainly in the liver cells and is difficult to detect in the surrounding blood, so that leaves the “two and a half”.
We often refer to “major triple-positive” as a combination of HBsAg, HBeAg and anti-HBc positive, indicating that the hepatitis B virus is actively replicating and is highly contagious. A “minor triple-positive” is a combination of positive HBsAg, anti-HBe and anti-HBc, which generally indicates that the hepatitis B virus is inactive, has stopped replicating or is low replicating, and is not or slightly infectious. HBc two positive, suggesting infection with hepatitis B virus, but the presence or absence of viral replication is not yet determined. One positive anti-HBs. This indicates that the hepatitis B vaccine has been administered and antibodies have been produced in the body.
The second indicator is HBV-DNA, which is the “golden indicator” of hepatitis B virus replication.
Some people may ask, testing the hepatitis B “two-and-a-half” can already reflect the hepatitis B virus has no replication, whether the infectious, why do we need to test HBV-DNA? The HBV-DNA is called hepatitis B virus deoxyribonucleic acid. Nucleic acid is the core part of the virus, where the genes of the virus are located, and without it, the virus cannot replicate. Therefore, testing HBV-DNA is the “golden indicator” to determine whether or not the hepatitis B virus has replicated.
By understanding the above, we know how to determine the condition of a patient with hepatitis B, so that we can decide if he needs to be treated and what kind of treatment to give.
These are the conditions of hepatitis B.
Then we will introduce the tests for hepatitis C.
Hepatitis C is also a blood-borne disease and is becoming more and more prevalent. In developed countries in Europe and the United States, it is the main liver disease. The main tests are hepatitis C antigen, antibody and HCV RNA. if there are abnormalities in liver function and hepatitis B is not detected, the possibility of having hepatitis C should be considered. It will be necessary to perform the above tests.
Other tests for hepatitis markers are tests for antibodies to hepatitis A and E. These two types of hepatitis are mainly transmitted through the digestive tract. If you may have hepatitis A and hepatitis E, you need to be tested for hepatitis A and hepatitis E antibodies.
In addition to having blood drawn for laboratory tests, imaging tests will also be performed. For example, ultrasound, CT, MRI, etc. Let’s start with ultrasound. For liver examination, ultrasound is very important, which is both simple, convenient and effective.
For the liver, which cannot be seen with the naked eye or touched directly by hand, when the liver is mildly enlarged and stones or masses appear in the liver, ultrasound is the most intuitive and economical examination method, and also has the advantages of being rapid, accurate and non-invasive, etc. The size and morphological changes of the liver can be understood by observing ultrasound echo images.
For example, in addition to a biochemical test, ultrasound is also an important test for liver cirrhosis and portal hypertension, which has a high diagnostic value. In early stages of cirrhosis, enlarged liver with dense parenchymal echogenicity is seen; in late stages, it shrinks and the surface of the liver is uneven and nodular. In portal hypertension, widening of portal vein and splenic vein diameter is seen, and fluid dark areas can be found in the presence of ascites.
For fatty liver, its clinical manifestations and laboratory tests lack specificity, so ultrasound becomes an important indicator for diagnosing this disease. Ultrasound examination of fatty liver shows microscopic dense strong reflective light spots in the liver parenchyma and diminished echoes in the deeper tissues. The diagnosis rate of ultrasound for severe fatty liver is 95%.
Ultrasound is the first choice of examination for liver cancer and is widely used in the early diagnosis and daily follow-up of liver cancer. Ultrasound examination of hepatocellular carcinoma is shown on sonogram as a solid dark area of cancer tumor with obvious reflected light spots, light clusters and light bands around.
There are many liver disease examination items, besides immunological examination, CT examination, magnetic resonance examination, tumor marker examination, biopsy of liver and so on, depending on the different stages of disease development.
To sum up the above, a reasonable liver disease examination is the baton for preventing liver disease, diagnosing liver disease and treating liver disease, and it is important not to neglect the necessary liver disease examination.