"Hepatitis-cirrhosis-liver cancer" is often called the trilogy of liver cancer. In a sense, liver cirrhosis is only one step away from liver cancer. There are about 7 million patients with liver cirrhosis in China, and 70% to 90% of them may develop liver cancer. So, how can patients with liver cirrhosis prevent or detect liver cancer early?
These liver cirrhosis are more prone to liver cancer
The risk of liver cirrhosis progressing to hepatocellular carcinoma (hereinafter referred to as liver cancer) is closely related to hepatitis B virus, hepatitis C virus infection, alcoholic fatty liver disease, non-alcoholic fatty liver disease, etc., and is related to race, age, gender, and family history Factors such as, concomitant diseases are also related to a certain extent. Treating the cause can help reduce the risk of liver cancer in patients with liver cirrhosis. In Asia, the main risk factors for liver cancer are hepatitis B virus infection, hepatitis C virus infection and alcohol intake.
The incidence of liver cancer in patients with liver cirrhosis of different causes is different. The study found that patients with liver cirrhosis due to hepatitis C virus (HCV) infection have the highest risk of liver cancer, with a cumulative incidence of 30% in 5 years; patients with liver cirrhosis due to hepatitis B virus (HBV) infection have 5 years of liver cancer The cumulative incidence rate is 15%-17%; the 5-year cumulative incidence rate of liver cancer in patients with alcoholic cirrhosis is 8%; the 5-year cumulative incidence rate of liver cancer in patients with primary cholestatic cirrhosis is 4%.
Prevention of liver cancer is the basis for treatment of causes
Research data shows that among the patients with hepatocellular carcinoma in my country, 86.0% are HBV infection, 1.7%~2.5% are HCV infection, and 6.7% are HBV and HCV mixed infection. Whether it is hepatitis B cirrhosis or hepatitis C cirrhosis, effective antiviral treatment can help prevent liver cancer. Nucleoside (acid) analogs and peginterferon-α are two major types of drugs for hepatitis B antiviral therapy. Clinical practice has shown that standardized antiviral therapy can reduce the risk of liver cancer. HCV infection can be cured by applying direct-acting antiviral drugs (DAA), which greatly reduces the risk of liver cancer. For patients with alcoholic liver cirrhosis, completely abstaining from alcohol is the most important and basic treatment and preventive measure.
In addition to treatment for the cause, patients with active liver cirrhosis can use anti-inflammatory and hepatoprotective drugs to inhibit inflammation under the guidance of a doctor, and can also choose drugs with anti-liver fibrosis effects to reduce liver cirrhosis and prevent liver cancer.
Regular screening, early detection of liver cancer
For some patients with liver cirrhosis, the occurrence of liver cancer may be inevitable, so early detection and early treatment are the "best policy." Standardized screening and monitoring are the key to early detection. The Chinese Society of Hepatology of the Chinese Medical Association issued the "Consensus on Secondary Prevention of Primary Liver Cancer (2021 Edition)", which put forward screening and monitoring recommendations for patients with liver cirrhosis: Serum A fetus Protein (AFP) combined with liver ultrasonography is a routine screening method for liver cancer, once every 3 to 6 months; patients with suspicious nodules or atypical space-occupying lesions found on ultrasonography should be further used multi-mode magnetic resonance or enhanced CT screening. An enhanced MRI scan using gadoxetate disodium, a hepatobiliary-specific contrast agent, can detect tumors below 1 cm.
