What are the primary liver cancer tests?

65438+

(1) Alpha-fetoprotein (AFP): AFP has relatively specific diagnostic value for hepatocellular carcinoma. On the basis of excluding pregnancy, hepatitis and gonadal embryoma, the criteria for AFP to diagnose hepatocellular carcinoma are:

① AFP > 500μ g/L for 4 weeks;

②AFP gradually increased from low concentration, but did not decrease;

③ The moderate level of AFP above 200μ g/L lasted for 8 weeks. In clinical practice, patients with low AFP concentration often need to be followed up by imaging diagnosis technology, which is helpful to establish diagnosis as soon as possible.

(2) Detection of other liver cancer markers;

① γ -glutamyltranspeptidase isoenzyme Ⅱ (γ-GT2). The positive rates of primary liver cancer and metastatic liver cancer are all above 90%, and the specificity is 9.

7. 1%。

② Abnormal prothrombin (AP).

In China, abnormal prothrombin ≥ 250μ g/L is determined by radioimmunoassay, which has high specificity for primary liver cancer and extremely low false positive rate for various non-cancerous liver diseases, secondary liver cancers and benign liver tumors.

③α-L fucosidase (AFU). Primary liver cancer should be considered when AFU exceeds110 kat/L. The positive rate of AFU in diagnosing primary liver cancer in China is 8 1.2%, and the positive rate of AFP-negative liver cancer and small liver cancer is 7.

6. 1% and 70.8%, secondary liver cancer and benign space occupying lesions of liver were negative, but the false positive rate of cirrhosis and chronic hepatitis was high.

4 others. Acid isoferritin (AIF), aldolase isoenzyme A(ALD-A), M2- pyruvate kinase (M2-PyK), α-antitrypsin (AAT) and pyruvate kinase (PyK) are increased in hepatocellular carcinoma, which has strong specificity.

2. Imaging diagnosis of liver cancer

(1) Real-time ultrasound imaging (US): Ultrasound imaging showed that with the gradual increase of small hepatocellular carcinoma, the internal echo changed from low echo to high echo and mixed echo. It is of great value for the localization and diagnosis of early tumors with diameter > 2 cm.

(2) Computed tomography (CT): It can reflect the pathological manifestations of the liver, such as the size, shape, location and number of lesions, and whether there is bleeding or necrosis in the lesions.

(3) Magnetic resonance imaging (MRI): MRI has no ionizing radiation and no contrast agent, and can perform three-dimensional imaging, which is superior to CT in the diagnosis of liver cancer.

(4) Angiography of primary liver cancer: The detection power of angiography for liver cancer depends on the number of new blood vessels in the focus, and multi-vessel liver cancer is easy to display even if it is less than 2cm or smaller. Digital subtraction angiography (DSA) has been developed in recent years.

(5) Radionuclide imaging: clinically applied to the qualitative and localized diagnosis of liver cancer, such as the qualitative diagnosis of AFP-negative liver cancer, the differential diagnosis of primary and secondary liver cancer, the diagnosis of extrahepatic metastases, and the diagnosis of hepatic adenoma.

3. Liver biopsy or cytological examination In recent years, real-time ultrasound or CT-guided biopsy or fine needle aspiration is an effective method to obtain the diagnosis of small liver cancer with a diameter less than 2cm.