liver and gallbladder disorders
Hepatocellular Carcinoma
Diagnosis of Hepatocellular Carcinoma
Physical examination Blood and imaging tests Detecting hepatocellular carcinoma early is difficult because at first, the symptoms do not provide many clues. If a doctor feels an enlarged liver or if an imaging test detects a mass in the upper right part of the abdomen during an examination done for other purposes, the doctor may suspect this cancer, especially in people with long-standing Cirrhosis of the Liver . However, screening programs often enable doctors to detect this cancer before symptoms develop. If hepatocellular carcinoma is suspected, the following are done: Blood tests to measure levels of alpha-fetoprotein (AFP):This protein is normally produced by the fetus, and levels decrease markedly by age 1 year. Levels are high in about half the people with hepatocellular carcinoma. Physical examination:Doctors feel the upper right part of the abdomen to check for an enlarged liver or mass. They may place a stethoscope over the liver to check for sounds caused by the cancer. For example, they occasionally hear rushing sounds (hepatic bruits, which are due to blood rushing through blood vessels inside the cancer) or scratchy sounds (friction rubs, which are due to the cancer rubbing against the liver surface and surrounding structures). Imaging Tests of the Liver and Gallbladder : If the diagnosis is still unclear, a Biopsy of the Liver (removal of a small sample of liver tissue with a needle for examination under a microscope) can confirm the diagnosis. To improve the chances of obtaining cancerous tissue, doctors often use ultrasonography or CT to guide the placement of the biopsy needle. The risk of bleeding or other injury during a liver biopsy is usually low. If cancer is diagnosed, doctors determine how large the cancer is and whether it has spread to nearby structures or other parts of the body. The imaging tests used for diagnosis can provide some of this information. The cancer is classified ranging from stage I (a single tumor that has not spread) to stage IV (spread to distant parts of the body). Staging helps doctors decide on treatment and estimate survival. In some areas where the Hepatitis B, Chronic virus is common, ultrasonography is used to screen people with hepatitis B for liver cancer. Doctors may periodically screen people with 