Cirrhosis and liver cancer

Cirrhosis


When liver inflammation is too high, exceeding its repair capacity, then by fibrous tissue to be repaired, long after they have formed a cirrhosis. Cirrhosis have a variety of reasons, most of cirrhosis, is due to three types of hepatitis (viral, alcoholic, drug-induced) evolution of the results, another has a small portion of liver cirrhosis is a hereditary and rarely see; such as primary biliary cirrhosis, α-anti-trypsin deficiency and Wilson's disease and so on. In Taiwan the most common is a result of hepatitis B virus and hepatitis C virus-induced, but no matter what the reasons are a result of, the clinical manifestations are similar.



Many patients with liver cirrhosis have no symptoms, so not through the regular inspection, we do not know they have have cirrhosis. Cirrhosis terrible place because of its complications: esophageal varices, hepatic coma, ascites (sometimes complicated by peritonitis), and liver cirrhosis patients have the opportunity to be transformed into hepatocellular carcinoma.



l esophageal varices: As liver cirrhosis due to inflow of the liver led to increased vascular resistance, resulting in hepatic portal vein pressure increased, which blocked the blood was back to block the vein to the esophagus to produce varices. In severe cases, esophageal varicose veins on the break down and lead to massive bleeding, so to see melena and substantial blood and so on. This is a very critical complications, if we do not get treatment, patients often died of excessive bleeding.



l hepatic encephalopathy: the liver is the body's largest detoxification organ, when liver cirrhosis, the liver had to deal with a number of toxins into the body on the go, and can cause severe hepatic coma (hepatic encephalopathy).



l ascites: When the hepatic portal vein pressure rise may also have ascites, the treatment of ascites method is usually restricted salt intake, and given diuretics and, if necessary, have to "rescue" (to be released to ascites in vitro). If so, then complicated by peritonitis, can be seen clinically with fever, abdominal pain and other phenomena, must be taken at this time to do the inspection and ascites bacterial culture to determine the diagnosis, and treatment modalities are given antibiotics.



Cirrhosis So far, no one drug could have come back to soften the liver sclerosis, that is to say, liver cirrhosis is not reversible, except for liver transplant, otherwise the situation is not improved.



Liver cancer


Cancer is an annual cause of death in Taiwan first, and in all of cancer, the number of people died of liver cancer is always among the best, and often are among the first people to become health hazards of the number one killer, so how to prevent liver cancer incidence and treatment of liver cancer has become a very important topic.



In the liver disease and liver cancer are closely related to viral hepatitis (B type, C type) and cirrhosis, is usually due to chronic hepatitis leading to cirrhosis and liver cancer have, of course, has not been the stage of liver cirrhosis directly into the liver of. Therefore, carriers of chronic hepatitis, cirrhosis and liver cancer have a family history of liver cancer incidence per capita are high-risk groups, should be inspected regularly to the hospital, and pay attention to their own lives and rest and eating habits.



Liver cancer early and Nothing special symptoms, it is necessary to rely on a number of checks can be found, such as blood-fetoprotein (α-fetal protein) (but about有三成liver are within normal range) and imaging (such as ultrasound, computer tomography). In addition the liver biopsy needle (which is on the ultrasound under the guidance of a long needle to draw the tumor cells) is more to confirm.



Liver cancer treatment has (1) surgery (2) blood clots (3) local ethanol injection (4) chemical treatment:



l surgical resection of liver cancer are all the methods, the traditional view that the best treatment, but the local high concentration of alcohol injection, has gradually been replaced by the trend. However, suitable for surgery, as determined from several aspects. First, the liver's own circumstances. Generally speaking, a single tumor are more suitable for surgery, multiple tumors in the liver as a result of spread can not be removed to clean, so each person must be in accordance with different medical conditions, make an individual assessment to determine suitability for surgery. In addition, the tumor size is not the main determinant. If liver cancer has been violated to the main hepatic portal vein, while not suitable for surgery. Second, the liver function itself. Because the majority of liver cancer patients who have cirrhosis, the Government must consider if the long-liver tumor after partial resection, the remaining liver is already hardened enough to cope with the needs of the body. Some patients have not received surgical treatment, because cirrhosis are too serious, poor liver function, rather than the treatment of liver cancer in itself can not. Third, the availability of other risk factors for surgery exist. For example, serious heart disease, lung disease, such as. Thus, although liver resection surgery has been quite safe, but because of the above reasons, making cancer patients suitable for surgery, only about two or so into.



l blood clots are generally used for patients not suitable for surgery or refuse surgery patients. Normal liver tissue of the blood supply by hepatic artery (or one quarter) and hepatic portal vein (accounting for three fourths) jointly completed. And liver cancer is almost entirely by the hepatic artery to supply, hepatic portal vein, what status did not account for. Thus the practice of blood clots is to supply the hepatic artery of tumor nutrition stuff, so there is no blood supply to cancer cells and thus necrosis. But not part of the liver tumors, although there is less lost a quarter of the blood flow, but because the supply has three fourths of hepatic portal vein blood flow, so will not result in necrosis.



l are the local ethanol injection therapy for small liver cancer, liver cancer, however some are not easy to reach ethanol injection at the location, so not all are suitable for small hepatocellular carcinoma by alcohol injection.



l chemotherapy for liver cancer treatment is not very good. Generally speaking, the above-mentioned three methods are used for patients who are unfit.



Liver cancer treatments are a variety of combinations depending on the patient's condition must choose a better way of treatment or combination therapy, so patients with liver cancer are the same, but the treatment can be different. But are the same, no matter what treatment modalities, is essential to early detection and treatment before they can achieve the best therapeutic effect. Furthermore, because the majority of patients with hepatocellular carcinoma by hepatitis → → liver cirrhosis evolved, so avoid becoming carriers of hepatitis B or hepatitis C infection, the prevention of liver cancer are another important step.