The day before yesterday (February 3rd), the news that Zhao Yingjun, a 43-year-old musician, died suddenly exploded on the Internet. According to his friend, he died of liver cancer.

Sadly, A Little Red Flower, the last work he left to the world, is also the theme song of an anti-cancer film with the same name.

While remembering, it is necessary for us to know about this heartless disease-liver cancer. Why does liver cancer always happen so suddenly? It seems to have been lurking around, just waiting for the violent attack at the last moment.

Is there really no signal at all in the early stage of liver cancer? How can we find its clues in time?

1. Why is liver cancer advanced once it is discovered?

According to WHO data, China accounts for more than half of the world's new cases of liver cancer and deaths, and it is the second highest cancer mortality rate in China. Liver cancer can be divided into primary and secondary types, in which secondary (metastatic) liver cancer refers to the metastasis of malignant tumors from other organs to the liver, with the metastasis of abdominal and pelvic organ cancers such as stomach, biliary tract, pancreas, colorectal cancer and ovary being the most common, while the liver cancer we usually refer to primary liver cancer. The cell types of primary liver cancer include hepatocellular carcinoma, cholangiocarcinoma and mixed cell carcinoma containing these two kinds of cells, among which hepatocellular carcinoma accounts for the primary liver cancer cases.

1. The early symptoms of liver cancer are not obvious:

The pain nerves of the liver are not sensitive, so there are generally no specific symptoms in the early stage of liver cancer, which is easy to ignore in life. When pain, abdominal distension, fatigue, jaundice, etc. occur, most of them are in the middle and late stage, and 8% of patients can no longer receive surgical treatment.

2. It should be noted that liver cancer can't be screened early only by checking liver function!

In addition to the strong concealment of liver cancer itself, many people have this misunderstanding in life, thinking that as long as the indexes of liver function are normal, the liver will not have problems, let alone grow tumors. In fact, the liver is the largest substantive organ of the human body, and its functions are very complicated, including synthesis, metabolism and detoxification, secretion, immunity and hematopoiesis.

1) What items do liver function tests include?

Liver function tests mainly include transaminase, bilirubin, albumin and other indicators, in which bilirubin reflects whether the metabolism and secretion function of the liver are normal, albumin reflects the synthetic function of the liver, and transaminase level reflects whether the liver cells are damaged. Through these three indicators, the damage of various functions of the liver can be basically determined, but it is difficult to screen the existence of liver tumors, and even if the liver has grown a lot of tumors, all functional indicators of the liver can remain normal for a long time. Why? The reason is that the liver has a strong ability of compensation and regeneration. Even after 6%-7% of normal people's liver is cut off, it can still maintain normal function. Imagine that unless the tumors are large and numerous, there may be obvious abnormalities in liver function.

2) In the early stage of tumor growth, liver function of patients with liver cancer will not be obviously damaged!

In this way, it is difficult to detect tumors early through liver function examination, but this does not mean that liver function examination is meaningless. If a person takes drugs or drinks a lot for a long time, or is infected with hepatitis virus, the liver may gradually appear diffuse damage, and if not intervened in time, it will develop into cirrhosis or even liver cancer. Therefore, it is necessary to carry out liver function examination regularly for these people and treat liver diseases in time; But if you want to screen liver cancer early through liver function, it is basically useless.

3) At present, there are two main methods for early screening of liver cancer:

One is B-ultrasound, which can usually find liver tumors over 1 cm; The second is to test tumor markers. If the indicators in the markers are abnormal, it indicates the possibility of cancer. For the high-risk population of liver cancer with a history of hepatitis, alcoholism and nonalcoholic fatty liver disease, it is best to have tumor screening every 3-6 months, and the non-high-risk population should also have tumor screening once a year.

Second, the occurrence of liver cancer is actually traceable!

among all cancers, the pathogenic factors of liver cancer are relatively clear, among which viral hepatitis is the most important reason. More than 8% of patients with liver cancer in China suffer from viral hepatitis, but many people do not know it, and their medical history is often discovered after being diagnosed with liver cancer. Therefore, personal detection of hepatitis should be strengthened. It should be noted that some viral hepatitis, especially chronic hepatitis, has no obvious liver injury in the early stage, so it is impossible to find problems through liver function examination. Etiological tests of corresponding viruses, such as two and a half pairs of hepatitis B and hepatitis C antibodies, should also be carried out to make it clear whether they have suffered from hepatitis.

Hepatitis-cirrhosis-liver cancer is called "trilogy of liver cancer"

According to epidemiological data, about 1% of viral hepatitis will develop into chronic active hepatitis, and 5% of the latter will develop into cirrhosis, and the probability of liver cancer in cirrhosis is about 9.9%-16.6%.

In China, hepatitis virus infection is one of the most important causes of high incidence of liver cancer, mainly hepatitis B and hepatitis C, which account for more than 8% of the total incidence of liver cancer. It is estimated that HBV carriers in China account for 8%-1% of the total population, and the total number exceeds 1 million, of which about 2 million are chronic hepatitis B patients. Such a huge high-risk population base is like a huge "reserve army" for liver cancer. If you want to stay away from liver cancer, you must be careful of the carcinogenic factors lurking around you.

3. Besides hepatitis virus, what other factors are related to liver cancer?

A review report on liver cancer in Journal of Oncology of American Medical Association sorted out the risk factors of liver cancer, and the first one was still viral infection such as hepatitis, followed by behavioral factors such as alcoholism, metabolic factors such as obesity and aflatoxin exposure.

1) Viral hepatitis

In the past, there were a large number of adults infected with hepatitis B in China. Without active antiviral treatment, there is a great risk of turning into liver fibrosis and cirrhosis, and then forming liver cancer. But at present, hepatitis B immunization is getting better and better. It can be said that there will be fewer and fewer people infected with hepatitis B virus in the future.

Reminder: Although hepatitis B is an infectious disease, it is not contagious in daily life, such as shaking hands, hugging, working and eating. Its transmission routes are mainly blood transmission, mother-to-child transmission and sexual transmission. Patients with hepatitis B should be treated according to the doctor's advice in time, and their family members should be advised to be screened, including liver function, hepatitis B five items, abdominal B ultrasound and so on.

2) aflatoxin

According to the data published in Journal of Oncology of American Medical Association, the standardized mortality rate (ASMR) of liver cancer in China decreased by 33% from 199 to 215, partly due to the reduction of aflatoxin exposure. Aflatoxin, a potential killer of liver cancer, how to prevent it in daily life

3) alcoholic hepatitis < P > Alcoholism is closely related to liver cancer, which can be supported by data all over the world: more than 45% of liver cancer patients in Boston, USA have alcohol addiction; Danish research found that more than half of patients with liver cancer in Copenhagen have alcohol addiction; Research on liver cancer in Britain found that 3% patients with alcoholic cirrhosis will get liver cancer.

experts predict that with the weakening of the influence of viral hepatitis and aflatoxin, the alcohol intake promoted by the strong "alcohol culture" will increase, which is likely to occupy an increasing proportion in the formation of liver cancer. Quitting smoking can not only directly avoid the invasion of various carcinogens, but also improve the body's immunity, reduce the occurrence of metabolic diseases, prevent fatty liver and stay away from liver cancer.

fourth, how to reduce the threat of liver cancer to human beings?

With the increase of age, influenced by metabolism, cell aging and various external factors, the possibility of cell mutation also increases. Generally speaking, the high-risk groups of liver cancer include: patients with chronic hepatitis; Family history of liver cancer; Long-term alcoholics; People living in areas with high incidence of liver cancer; Drinking water with excessive heavy metal content; Long-term high-fat diet.

The above-mentioned high-risk groups are prone to develop liver cirrhosis in different degrees. Besides the prevention of living habits, necessary physical examinations are needed:

1) Regular physical examinations:

Health examinations are effective measures for early detection of liver diseases, such as liver ultrasound, liver function examination, hepatitis B-5, HBV-DNA, blood routine and AFP, which can effectively detect liver diseases. For high-risk groups, regular liver screening should be done at least once every six months. The main items include B-ultrasound, liver function and serum alpha-fetoprotein (AFP) detection, which can effectively detect early liver cancer.

2) Do not abuse drugs

Some antibiotics, painkillers, birth control pills, hypoglycemic and lipid-lowering drugs, cold medicines and some Chinese herbal medicines may damage liver function. To take medicine according to the doctor's advice, we should not be superstitious about folk remedies and so-called "liver-protecting drugs", "immune-enhancing drugs" and "nutritional drugs" in advertisements, and should never abuse them.

3) Close the entrance

Don't eat moldy rice, corn, peanuts and other foods to ensure the safety and hygiene of drinking water; Residents in hot and humid southern areas should reasonably store grain and vegetable oil to prevent mildew; Eat less fried food every day and avoid eating too much high-fat, high-salt and high-oil food.

4) Early treatment

Patients with chronic hepatitis should receive antiviral treatment as soon as possible to control the replication of hepatitis virus; Alcoholic liver disease should stop drinking as soon as possible; Fatty liver should reasonably control diet and weight, strengthen exercise and treat primary diseases.

physical examination reminder