Early stage liver cancer was initially defined as primary liver cancer with a single cancer nodule with a maximum diameter of less than 3 cm or two cancer nodules with a combined maximum diameter of less than 3 cm. In recent years, the definition of early-stage hepatocellular carcinoma has changed with the continuous advancement of hepatocellular carcinoma treatment. Currently, primary liver cancer with a single nodule <2cm is called very early stage liver cancer.
early stage), primary liver cancer with a single nodule of 2-5 cm or 3 nodules of <3 cm in diameter is called early stage liver cancer.
stage). As early stage liver cancer has no symptoms, it is very difficult to be detected clinically. Once liver cancer patients have symptoms, they are often in the middle or late stage, and the early or late detection of liver cancer directly determines the choice of treatment plan and prognosis, therefore, it is clinically important to detect early stage liver cancer. Therefore, early detection of liver cancer is clinically important. Based on my clinical experience in treating liver cancer for many years and referring to the latest literature, I would like to talk about the early detection of liver cancer. 1. First of all, determine whether you belong to the high-risk group of liver cancer The high-risk group of liver cancer refers to the group prone to liver cancer, including: chronic hepatitis B patients aged >40 for men and >50 for women; cirrhotic patients (alcoholic, primary biliary, viral); hepatitis C patients; hepatitis B patients with family history of liver cancer; long-term alcoholics; long-term consumption of food contaminated by aflatoxin, such as moldy food, etc. Since most of the early stage liver cancers have no clinical symptoms, early detection of liver cancer must rely on laboratory tests. If you are sure that you belong to the high-risk group, you should check your AFP and liver ultrasound every 6-12 months, so that most early liver cancers can be detected. It is important to note that it is best to have both tests done at each checkup. Some people, in order to save money, only check one item at each check-up or alternate the tests (e.g. AFP one time and ultrasound the next), which is not advisable and will not help detect liver cancer at an early stage. For patients with liver cirrhosis, if conditions allow, it is better to check the liver CT every once in a while (for example, 2-3 years) on the basis of the above checkups. 3. Understand the clinical significance of each examination Because of the lack of medical knowledge, many people do not know much about the significance of each examination. Outpatient physicians have limited time and can only tell patients what needs to be done without saying why it should be done. Therefore, it is necessary to understand for ourselves the significance of these tests. First of all, AFP is not elevated in all patients; clinical statistics show that only 50-80% of liver cancer patients have elevated AFP. Therefore, only checking AFP is not enough. In addition, even for patients with elevated AFP, the elevated AFP may not be obvious in the early stage and may be easily overlooked. If AFP is persistently elevated, it must be given high attention. Besides, ultrasound examination. The possibility of detecting >1cm liver cancer by color ultrasound is 65-80%, which means out of 100 liver cancer patients, color ultrasound can only detect 65-80 liver cancer patients, and 20-35 patients will be missed. Therefore, both tests must be done to improve the detection rate. AFP is not only expressed in hepatocellular carcinoma, but also elevated in some other cases, therefore, it is not necessarily liver cancer when AFP is elevated. Ultrasound can detect liver occupancy, but sometimes it cannot determine benign or malignant. If ultrasound detects liver occupancy and cannot identify benign or malignant, it should enter the diagnosis process of hepatocellular carcinoma (see the latest diagnosis and treatment plan of hepatocellular carcinoma in this website). 4. Individuals must pay attention Because early detection of liver cancer directly determines the choice of treatment plan and prognosis, so high-risk groups must pay attention to it. In fact, many high-risk patients avoid this issue because of their fear. The reason for this fear is the misconception that “cancer is incurable”. Of course, there is a reason for this misconception. In the past, due to the backward treatment technology, many cancers were treated only after the middle and late stages, so the efficacy was poor. However, with the development of science and technology, we have the ability to detect all kinds of cancers at an early stage. In fact, with the continuous progress of liver cancer treatment protocols, liver cancer can be completely treated if detected early, as well as other cancers. Therefore, cancer must emphasize early detection and early treatment.