General morphological classification

Histological classification

Hematogenous metastasis: the earliest and most common

Lymphatic metastasis: mostly to portal lymph nodes

planting transfer

It mostly presents with persistent swelling and pain or dull pain. Liver pain is caused by the traction of the liver capsule by the rapidly growing tumor. If the disease invades the diaphragm, the pain may involve the right shoulder. When the cancer nodules on the liver surface rupture and the necrotic cancer tissue and blood flow into the abdominal cavity, severe pain may suddenly occur, extending from the liver area to the entire abdomen; symptoms of acute abdomen may occur, such as excessive bleeding, which may cause shock and syncope.

The liver is progressively enlarged, hard in texture, uneven in surface, with nodules or huge masses of varying sizes, with blunt and irregular edges, and often varying degrees of tenderness. When liver cancer protrudes under the right costal arch or xiphoid process, the upper abdomen may appear partially bulging or full. If the cancer is located on the diaphragm surface, the main manifestation is diaphragm elevation but the lower edge of the liver may not be enlarged. Cancerous nodules located under the costal arch are most easily palpable. Sometimes cancer compresses blood vessels, and a blowing murmur can be heard in the corresponding abdominal wall area.

Patients with cirrhosis and portal hypertension may have symptoms such as splenomegaly, ascites, and formation of venous collateral circulation. Ascites quickly increases and is usually transudate. There may be bloody ascites, mostly caused by cancer invading the liver capsule or rupturing into the abdominal cavity.

Progressive weight loss, loss of appetite, fever, fatigue, malnutrition and cachexia, etc. A small number of liver cancer patients may have special systemic manifestations, called cancer-associated syndrome. Spontaneous hypoglycemia and polycythemia are more common, while other rare ones include hyperlipidemia, hypercalcemia, carcinoid syndrome, etc.

Intrahepatic hematogenous metastasis is early, and most of the metastases are to the lungs, adrenal glands, bones, chest, brain and other parts, causing corresponding symptoms. The thoracic metastasis is more common on the right side, and there may be signs of pleural effusion.

Regular observation of AFP is of great value in judging the condition of liver cancer, postoperative recurrence and estimating prognosis. Standards: ① AFP >500 μg/L for 4 weeks ② AFP gradually increases from low to not falling ③ AFP remains at a moderate level above 200 μg/L for 8 weeks.

The best way to diagnose small and micro liver cancers

Surgical resection is currently the most effective treatment for early-stage liver cancer

Indications for surgery

Non-surgical method of choice