China is a big hepatitis B country, and the correlation between hepatitis B virus and liver cancer is very high. We often encounter patients who know that they are carrying hepatitis B virus, but they do not take it seriously because they do not have any symptoms and they can eat and move. So is there a way to avoid the above situation? The answer is yes, and that is to have a review. How to review? Some patients only check the “two-and-a-half” test every year, thinking that they can rest easy if they are “small triplets”, but they do not know that this is the reason why they cannot detect the disease at an early stage. This is because even a “minor triple positive” does not indicate that there is no inflammatory activity in the liver. The first thing to look for in the liver is whether there is general weakness, poor eating, inability to eat greasy food, and a significant decrease in alcohol consumption. The second is to see if there is any damage to liver function, i.e. whether there is an increase in transaminases, bilirubin, globulin, and a decrease in albumin, which requires a blood test for liver function. The third is to see if the liver is gradually shrinking and the spleen is gradually increasing, which can be learned from ultrasound examination, which requires dynamic observation to be more meaningful, i.e. the ultrasound results of liver, bile and spleen before and after several times are compared with each other to find out the problem. Many patients think that the results are useless after each ultrasound examination and throw away the report card, which is a pity. The fourth item is to check the liver cancer marker, namely, alpha-fetoprotein (AFP), which can be significantly elevated before the liver mass is detected by ultrasound, CT or MRI, i.e., it can detect primary liver cancer at an ultra early stage, and ultrasound + tumor marker examination is currently recognized as the most effective method and a mature technology in the medical field to detect primary liver cancer at an ultra early stage. Qualitative examination can be done in all county hospitals, but a positive test does not mean that it is liver cancer, it still depends on how high the concentration of AFP is, which requires quantitative AFP examination. Therefore, the liver function and ultrasound must be checked during the review, and AFP must be checked for people over 30 years old, while the “two-and-a-half” test is secondary, because the “two-and-a-half” test can only reflect the replication status of the virus, but not the inflammation of the liver. Some patients do not have any symptoms and the transaminases are not high, but the liver gradually shrinks and the spleen gradually increases in size on ultrasound, which also indicates active inflammation of the liver and requires active treatment, otherwise it will easily lead to cirrhosis. So, how often is it good to review? It is generally believed that people under 30 years old have less chance to develop liver cancer and should be examined once every six months, but of course, if there are symptoms, we cannot wait for six months and should examine them immediately. Many patients may ask, “Why do we need to check so often? There is a reason: people over 30 years old have an increased chance of developing liver cancer, and the time to double the size of liver cancer is about 3 months. In the super early stage of liver cancer, AFP is obviously elevated, but ultrasound, CT and MRI cannot detect the lump. 3 months later, the lump may be detected in ultrasound, CT and MRI, and at that time, surgical resection can be cured, so it is best to check once every 3 months.