I. What is liver cancer? Liver cancer refers to malignant tumors occurring in the liver, including primary liver cancer and metastatic liver cancer, and people mostly refer to primary liver cancer when they talk about liver cancer in daily life. Primary liver cancer is one of the most common malignant tumors in clinical practice. According to the latest statistics, the global incidence rate has exceeded 626,000/year, ranking 5th among malignant tumors: death is close to 600,000/year, ranking 3rd among tumor-related deaths. Primary liver cancer is highly prevalent in China, and the number of incidences in China now accounts for about 55% of the world; it ranks second after lung cancer in tumor-related deaths. Liver cancer is a serious threat to people’s health and life in China. Who are prone to get liver cancer? 1. Chronic hepatitis patients: Epidemiological statistics show that areas where hepatitis B is prevalent are also areas with high incidence of liver cancer, and people who have suffered from hepatitis B have more chances to develop liver cancer than those who have not, and the risk is as high as 10.7 times. Hepatitis viruses including hepatitis B and C are the main initiating factors among many factors in the development of human liver cancer. 2, unclean diet: Long-term consumption of moldy food, food containing nitrite and the lack of trace elements of selenium in food are also important factors in the development of liver cancer. Aflatoxin in moldy corn, peanuts, etc. is the main factor that induces cancer, and is the only substance that has a clear carcinogenic effect so far, and is one of the auxiliary causes of liver cancer. Nitrite exists in many foods in nature, and nitrite in daily meals will not cause harm to human body, but if large amount of nitrite is not discharged in time, it can be turned into nitrosamines in the body, which has clear carcinogenic effect. 3.Alcoholics: Those who have alcoholic habits have a high incidence of cirrhosis, especially on the basis of hepatitis, drinking a lot of alcohol will accelerate the formation and development of cirrhosis and promote the occurrence of liver cancer. Strictly speaking, alcohol consumption is not the direct cause of liver cancer, but it is a catalyst that can promote the carcinogenic effect of carcinogens. How to detect liver cancer at an early stage? According to the “Expert Consensus on Standardized Diagnosis and Treatment of Primary Liver Cancer”, for those who are at high risk of liver cancer, i.e. men aged ≥ 35 years old, those with hepatitis B and/or C virus infection, and alcoholics, screening tests are generally conducted every 6 months, mainly including serum AFP and liver ultrasound. For those with AFP > 400 μg/L and no liver occupancy detected by ultrasound, attention should be paid to exclude pregnancy, active liver disease and germinal gland embryonic-derived tumors; if they can be excluded, liver CT and/or MRI should be performed. If AFP is elevated but not at the diagnostic level, in addition to the above-mentioned conditions that may cause AFP increase, the dynamic changes of AFP should be closely tracked, the interval of ultrasound examination should be shortened to one to two months, and CT and/or MRI examination should be performed when needed. What should I do if I have liver cancer? Liver cancer is not terrible because there are many treatment methods for liver cancer, which involve many disciplines. At present, the general principle of liver cancer treatment is early detection and early diagnosis, and the implementation of standardized and comprehensive treatment is emphasized. The common treatment methods for liver cancer can be divided into surgical and non-surgical treatments. Surgical treatment, including liver transplantation and hepatectomy, is the preferred treatment for liver cancer, which can completely remove tumor tissues and achieve the purpose of radical treatment. At present, about 4,000 liver transplants are performed in China every year, and the technology has become very mature, among which the proportion of liver transplant patients with liver cancer accounts for 40%. The long-term survival rate and tumor-free survival rate of liver transplant patients with liver cancer are significantly better than those who receive liver resection treatment. Non-surgical treatment for liver cancer includes hepatic artery infusion chemoembolization, local ablation therapy (radiofrequency ablation, microwave ablation, alcohol injection, high-intensity focused ultrasound), radiotherapy and molecular targeted therapy, which are mainly used for patients who cannot receive surgical treatment due to various reasons, or as adjuvant treatment before and after surgery. Arterial chemoembolization, which is often referred to as interventional therapy, is the first choice of non-surgical treatment and is often used for patients with mid- to late-stage liver cancer that cannot be surgically resected. For early stage liver cancer patients with single tumor of ≤125px in diameter or multiple nodules (within 3) with maximum diameter ≤75px, without vascular-biliary invasion and good liver function, radiofrequency or microwave ablation is the best alternative to surgery. For patients with advanced hepatocellular carcinoma, sorafenib, a molecularly targeted drug introduced in the past two years, can also delay tumor progression and significantly prolong survival, bringing hope for improved prognosis for hepatocellular carcinoma patients.