What are the preventive methods of primary liver cancer?

There are many ways to prevent primary liver cancer. Here are some of them, I hope they can help you.

Active prevention and treatment of viral hepatitis is of great significance to reduce the incidence of liver cancer. Preventive injection of inactivated hepatitis B vaccine is not only effective for the prevention and treatment of hepatitis, but also plays a certain role in the prevention of liver cancer. Avoid unnecessary blood transfusion and application of blood products. Preventing grain mildew, improving drinking water quality and giving up drinking habits are also important measures to prevent liver cancer. In the case of imperfect primary prevention of liver cancer, early detection, diagnosis and treatment of liver cancer are very important, which is called "secondary prevention" in oncology.

1. Population prevention of liver cancer is one of the most common malignant tumors in China, with about 1 10000 cases every year, accounting for about 40% of the world's cases. At present, the prevention and treatment of liver cancer has been included in China's prevention focus, in order to control the incidence of liver cancer and reduce mortality. The focus of population prevention of liver cancer is primary prevention and population census or screening.

Primary prevention of liver cancer refers to preventing the occurrence of liver cancer, so that people can avoid or contact with known carcinogenic factors and risk factors as little as possible. According to the etiological study of liver cancer, China has taken the strategic measures of "water control, grain management and hepatitis prevention" or implemented the first-level prevention of "hepatitis prevention, grain management and mildew prevention, proper selenium supplementation and water improvement". Details are as follows:

(1) Controlling water and improving drinking water hygiene: Organic pollution in drinking water is related to the occurrence of liver cancer. It is suggested that drinking highly polluted surface water, adding chlorine water and high concentration chloroform will increase the risk of cancer, which may come from a variety of carcinogens with additive and synergistic effects in drinking water pollution. Another study shows that drinking water and HBV carrying status have obvious synergistic effect on the pathogenesis of liver cancer.

At present, it has been found that there are many carcinogens in drinking water in areas with high incidence of liver cancer. Although the content of each carcinogen in these polluted water bodies is very small, after long-term intake, the concentration of all carcinogens can reach the threshold of carcinogenicity. Therefore, many scholars believe that improving water, managing water and improving drinking water hygiene may help reduce the incidence of liver cancer. In recent years, residents in Qidong County have strengthened the management of drinking water, and most residents have changed to drinking deep well water that meets the sanitary standards. The survey shows that the incidence of liver cancer has dropped significantly. Fusui county combined with farmland water conservancy construction, the county improved drinking water in a large area, and most residents drank deep well water and water conservancy water, which received good results.

(2) Strengthen mildew prevention and detoxification of grain, oil and food: reduce the intake of aflatoxin and block or inhibit the carcinogenic effect of aflatoxin. In areas with high incidence of liver cancer, the incidence of liver cancer is positively correlated with grain mildew, especially aflatoxin pollution in corn. In view of the fact that the mildewing links of grain mainly exist in the field harvest period, post-harvest treatment period and storage period, many scholars believe that it is extremely important to strengthen the mildewproof measures in these links. In addition, changing planting habits, replacing corn with rice and promoting rice consumption are also one of the ways to reduce aflatoxin intake.

For grain and oil foods that are moldy and cannot be discarded, some toxins can also be removed by selecting moldy particles and subtracting them.

(3) Blocking HBV infection and actively preventing and treating hepatitis: Hepatitis B virus infection is a serious public health problem at present. In areas with high incidence of liver cancer, the carrier rate of hepatitis B virus is also high, and 80% of patients with liver cancer are infected with hepatitis B virus. In patients with liver cancer, it was found that the DNA of hepatitis B virus was integrated into the DNA of liver cells. Therefore, blocking HBV infection is an important way to prevent primary liver cancer, and inoculation of hepatitis B vaccine is the most fundamental and effective measure to control hepatitis B. WHO pointed out that vaccines should be used selectively in areas with low HBV prevalence. In middle and high epidemic areas, all infants should be vaccinated, and the application of hepatitis B vaccine should be included in the Expanded Programme on Immunization. Practice has proved that the immune effect of newborns, especially newborns with HBsAg positive and/or HBeAg positive mothers, is reliable. By the end of 1990 in Qidong, 4 17 17 newborns had been vaccinated, the vaccination rate reached 98.6%, and the anti-HBS positive rate reached 82% at the age of 5. At present, chronic hepatitis is on the decline. The long-term effect of hepatitis B vaccine in preventing liver cancer needs further observation and confirmation.

(4) Drug prevention for high-risk population of liver cancer: Studies at home and abroad believe that increasing selenium level may help reduce the incidence of liver cancer. In New Zealand, the use of sodium selenite particles in the fields of low-selenium farms and spraying selenium fertilizer on the land of Denmark have changed the local selenium deficiency. In Qidong County, China, 380,000 people in low selenium areas were tested for prevention. By spraying selenium fertilizer on crops, the selenium level of corn and barley has increased six times, and the blood selenium level of residents has also been greatly improved. Animal experiments suggest that selenium can significantly inhibit hepatitis and precancerous lesions. The anticancer effect of selenium is mainly manifested in inhibiting the formation of proliferative lesions in the early stage and inhibiting the canceration of proliferative lesions in the late stage. The recent Sino-US cooperative intervention experiment in Qidong County showed that after taking selenium salt (15mg/kg) and selenium yeast preparation for four years, the standardized incidence of liver cancer in the population decreased from 42/65438+ million to 30/65438+ million, but the incidence in the control group did not decrease, and the difference was significant. Practice has proved that it is safe and feasible to supplement selenium in the site with high incidence of liver cancer. The value and significance of selenium in preventing liver cancer are explained.

Levamisole, vitamin A and vitamin C are also reported at home and abroad. China is rich in traditional Chinese medicine and natural food, so it is worth exploring to develop this treasure house for preventing liver cancer. Recently, green tea has been studied a lot. The results showed that green tea had obvious inhibitory effect on rat liver cancer induced by aflatoxin B 1, and it was also observed that green tea extract had inhibitory effect on the precancerous lesion of rat liver cancer induced by diethylnitrosamine. The epidemiology of high incidence areas of liver cancer also suggests that green tea may have a certain preventive effect. In addition, some traditional Chinese medicines for treating hepatitis, such as Salvia miltiorrhiza, Schisandra chinensis, lentinan and Coriolus versicolor polysaccharide, have the effect of antagonizing the formation of rat liver cancer caused by aflatoxin.

(5) Health publicity and education and the implementation of relevant administrative regulations: Primary prevention is a social work aimed at large-scale people, involving a wide range, high cost and great resistance, and it is difficult to show results in a short period of time. Therefore, it is an important condition to carry out health publicity and education in a planned, organized and targeted manner to raise public awareness of cancer prevention, and relevant administrative means and regulations should be adopted when necessary.

Primary prevention of liver cancer is very important and has great potential in reducing liver cancer, but at present, secondary prevention with practical effect should still be emphasized. In population prevention, it is an important aspect of secondary prevention to carry out general survey or screening of liver cancer and find liver cancer early.

① Survey object: Before 1980s, there was a big contradiction in the general survey of liver cancer in China, that is, the contradiction of "cost and benefit". According to the general survey among the natural population, even in the high incidence area of liver cancer like Shanghai, the detection rate is only 14.7/65438+ 10,000, which is very costly and ineffective. Since 1980s, according to the results of epidemiological investigation, the high-risk population of liver cancer has been divided, so the general survey of liver cancer has changed from natural population to high-risk population, the detection rate has been greatly improved, and the contradiction between cost and benefit has been well solved. This concept has also been accepted by medical workers. It is generally believed that the high-risk population refers to people over 40 years old who are positive for HBsAg and have a history of chronic hepatitis for more than 5 years (people who had hepatitis five years ago), especially men and people with family history.

② Census method: Simple, sensitive, accurate and reliable detection methods must be adopted in large-scale population census. The hemagglutination method of alpha-fetoprotein (AFP) roughly meets this requirement. The lowest positive limit of AFP hemagglutination method is 40? G/L, the false positive rate is 30%, and every AFP hemagglutination positive case should be examined by radioimmunoassay. Those who do have high AFP should be advised to go to a specialized hospital for examination.

The positive rate of AFP detection in patients with primary liver cancer in China is about 70%, that is, about 1/3 patients are difficult to find early by AFP detection. Other markers of liver cancer other than AFP are not suitable for general survey for various reasons. The clinical application of B-ultrasound has been proved to be a simple, accurate and reliable imaging diagnosis method, which has been gradually included in the general survey of liver cancer in recent years. The combined detection of B-ultrasound and AFP has indeed solved the problem of early detection of liver cancer with negative AFP.

③ Interval of census: The reports of scholars are basically the same. It is generally believed that for high-risk groups, a census should be conducted at least once every six months.

④ Organize general survey: widely publicize the knowledge of cancer prevention and treatment and the importance of early detection of cancer through various channels, especially pay attention to the publicity of high-risk groups, so that they can be taken seriously and checked regularly to avoid unnecessary tension.

To do a good job in the general survey, we must mobilize the enthusiasm of medical staff in grass-roots medical and health institutions such as factories, mines and enterprises, do a good job in mobilizing and organizing the investigated objects, and regularly check and supervise the close follow-up of AFP cases.

2. Personal prevention

(1) Primary prevention: Personal primary prevention should be carried out on the basis of population prevention. Besides consciously accepting crowd preventive measures, we should also take corresponding measures according to the pathogenic factors.

(2) Secondary prevention: Secondary prevention of liver cancer refers to early detection, early diagnosis and early treatment, that is, prevention of clinical attacks of liver cancer. People at high risk of liver cancer should regularly check AFP and B-ultrasound, at least once every six months, so that many patients with liver cancer can get early diagnosis. The purpose of early diagnosis is early treatment, and early liver cancer should be surgically removed as much as possible in order to achieve the goal of radical cure. Some scholars have pointed out that the purpose of secondary prevention of liver cancer is to save patients' lives, and should not be satisfied with prolonging the survival time after diagnosis, because this extension of survival time includes a period of survival time brought by early detection before clinical symptoms appear.

(3) Tertiary prevention: In addition to early detection and radical surgery, a large number of patients have been cured due to the clinical progress of liver cancer surgery, secondary surgery for recurrent liver cancer and secondary surgery after "large liver cancer becomes small liver cancer". After radical operation, patients should still be closely followed up regularly, and AFP and B-ultrasound should be checked every 1 ~ 3 months, so as to find recurrent liver cancer early, and take drugs to protect liver and improve immunity to prevent recurrence of liver cancer. For patients after palliative treatment, a series of comprehensive measures should be taken, such as transcatheter arterial chemoembolization, local alcohol injection, radiotherapy, immunotherapy and traditional Chinese medicine treatment, to delay the survival of patients and improve their quality of life.