Liver function test is normal, why do you still get liver cancer?

Many people think that normal liver function tests prove that their liver is healthy.

Although most people are like this, some people find that their liver function is normal, but they have cirrhosis or advanced liver cancer.

There was once a 40-year-old patient with liver cirrhosis in the clinic. Hepatitis B virus carried by mother and baby only checks the liver function every year, and the liver function is normal. He doesn't care. Later, he suddenly had a particularly painful liver area, so he went for an in-depth examination and found that it was early cirrhosis!

Why on earth is this?

Is liver function test useless?

Why does the doctor want me to spend more money on B-ultrasound and CT?

Normal liver function does not mean normal liver.

First of all, you should know that the liver is a "dumb organ". As long as the remaining 1/3 hepatocytes operate normally, it will not affect the metabolism of the body. Sometimes I feel healthy when I see that this person can eat and drink. Maybe a tumor has quietly grown on his liver.

Therefore, regular physical examination is necessary. First, it is necessary for high-risk groups; Second, for people with bad living habits, such as staying up late, drinking too much, eating too greasy, etc. Over time, these will have an impact on the liver.

Then, let's talk about why the liver function is normal but the liver may be abnormal.

Then why do you need to check your liver function?

Because:

For most ordinary people, this examination can basically understand the health of the liver. Therefore, it is generally not necessary to spend more money to check.

For hepatitis patients or people with a history of hepatitis, or some high-risk groups, this kind of examination can not fully reflect the health status of the liver. There may be the above possible conditions, normal liver function, and finally cirrhosis.

Therefore, doctors will repeatedly tell patients in outpatient clinics or outpatient clinics that they should integrate all aspects and indicators to analyze and evaluate the condition as a whole.

The liver is healthy. What should I check?

Common liver health checks include:

1. Liver function test

Basic, suitable for all ordinary people.

Liver function test reflects whether the synthesis, metabolism, detoxification and digestive function of the liver are normal. It can help most ordinary people to evaluate their liver health. It can detect and diagnose some diseases as soon as possible, such as acute and chronic hepatitis, alcoholic hepatitis, drug-induced hepatitis and other hepatobiliary diseases.

Disadvantages: But routine liver function tests detect transaminase, protein, bilirubin, etc. In peripheral blood, it can only indirectly reflect the functional state of the liver, but not the morphological changes of the liver. It is impossible to completely judge the situation of liver cirrhosis and cancer.

It is recommended to consult a doctor to interpret the results of liver function test. If you want to see for yourself, generally speaking, a slight increase in transaminase is of little significance, but abnormal bilirubin and protein indicators need to be vigilant and go to the hospital for further examination.

2. Liver B-ultrasound examination

Look at the liver.

B-ultrasound examination of the liver is often done in the morning, because an empty stomach is needed. Liver B-ultrasound is like a "small mirror", which allows us to "see" the situation of the liver. For example:

Know something about fatty liver,

Are there cysts in the liver,

Any hepatic ascites,

The situation of liver tumor,

Are there stones in bile duct and hepatic duct? ...

Under B-ultrasound, a healthy liver is transparent, and B-ultrasound light can penetrate the liver.

Fatty liver under B-ultrasound, the blood vessels and bile ducts on the liver are blurred, and B-ultrasound light cannot penetrate.

Advantages and disadvantages: Compared with other examinations, B-ultrasound is simple, harmless and painless, and the cost is relatively low. However, some space-occupying lesions, such as tumors and parasites, cannot be detected by B-ultrasound when they are less than 1 cm. Some mild fatty liver may not be detected.

So there are often B-ultrasound combined with other tests, such as:

"B-ultrasound+fibrosis detection" can detect liver cirrhosis early.

"B-ultrasound +AFP" can detect liver cancer early.

3. Alpha fetoprotein

Early cancer judgment

Alpha-fetoprotein is a specific marker of liver cancer, which has the function of early diagnosis and differential diagnosis of primary liver cancer. It is a common screening method for liver cancer, which is simple and practical.

It takes about 5 years for a normal tissue cell to evolve into a solid tumor with a diameter of about 0.5- 1 cm. In this process, X-rays, B-ultrasound and other common means can't be detected.

4. Five items of hepatitis B (two and a half items) and five items of hepatitis C.

Infectious disease examination

Five tests for hepatitis B, that is, we often say two and a half. The five tests of hepatitis B and hepatitis C are to check whether hepatitis B and hepatitis C are infected and the specific situation of infection from an epidemiological point of view.

After all, if viral hepatitis is not controlled, it will easily develop into cirrhosis or even liver cancer.

5. Quantitative detection of 5.HBV DNA.

Essential for patients with hepatitis B.

For patients with hepatitis B, because the two halves of hepatitis B can not accurately judge the virus replication, it is necessary to further quantitatively detect the DNA of hepatitis B virus.

This test can accurately reflect the activity of hepatitis B virus in serum and judge the infectivity of hepatitis B, and it is also an evaluation index of antiviral treatment.

6.CT and MRI

See more clearly

B-ultrasound is used for routine examination. If problems are found in the examination, they should be further diagnosed by CT or magnetic vibration. For some difficult cases, CT and magnetic resonance are needed to make a definite diagnosis.

CT examination is an important means to find liver cancer, which can clearly show the size, shape, number and boundary of the tumor. In addition, according to the image analysis, we can reconstruct each duct in the liver, and we can accurately understand the relationship between the blood vessels in each liver segment and the tumor.

How to choose a physical examination?

In a word, it is enough for normal healthy people to know their liver health through liver function test.

However, some high-risk groups or patients with liver diseases need to do some systematic examinations, such as liver B-ultrasound, pathology, HBV DNA, serum alpha-fetoprotein and so on, in order to make a correct judgment on health.

1, 6 months to do B-ultrasound+AFP.

People who have been infected with viruses such as hepatitis B and hepatitis C;

Cirrhosis;

There are patients with liver cancer at home;

Severe fatty liver;

People in high-risk areas of liver cancer: In China, there are high-risk areas of liver cancer, such as Fusui in Guangxi, Qidong in Jiangsu, Shunde in Guangdong and Tongan in Fujian. It may be related to the existence of different degrees of Aspergillus flavus pollution in grain.

It is best for these people to do B-ultrasound and alpha-fetoprotein once every six months to know the health status of their liver.

2. Have a physical examination once a year.

Over 40 years old;

Love to drink;

Fatty liver and so on.

Such people suggest a physical examination once a year and a liver function test. If any abnormality is found, consider doing the above inspection according to the doctor's advice.