Introduction of etiology
The main causes of liver cancer in China are hepatitis virus infection, food aflatoxin pollution, long-term alcoholism and cyanobacteria toxoid pollution in rural drinking water, as well as other liver metabolic diseases, autoimmune diseases, cryptogenic liver disease or cryptogenic cirrhosis. Because early diagnosis of liver cancer is very important for effective treatment and long-term survival, early screening and early monitoring of liver cancer are emphasized. Routine monitoring and screening indicators mainly include serum alpha fetuses. Alpha-fetoprotein (AFP) and liver ultrasound (US). For what? 40-year-old male or? 50-year-old women with family history of HBV and/or HCV infection, alcoholism, diabetes and liver cancer are usually examined every 6 months. It is generally believed that,
AFP is a relatively specific tumor marker of HCC, and the continuous increase of AFP is a risk factor for HCC. Recently, some European and American scholars think that the sensitivity and specificity of AFP are not high, and the 20 10 version of the American Society for Liver Disease Research (AASLD) guideline no longer uses AFP as a screening index. However, most of HCC in China is related to HBV infection, which is different from the pathogenic factors of HCC in western countries (mostly HCV, alcohol and metabolic factors). Combined with the domestic (RCT) randomized research results and the actual situation, AFP continues to remain in the routine monitoring and screening indicators of HCC. The main reasons are:
1. toxin: There are a lot of aflatoxins in moldy and burnt food or grain, which is an important factor causing liver cancer, so we should pay attention to food and food storage in our lives.
2, alcoholism: excessive drinking will cause alcoholism, and may also cause alcoholic fatty liver and alcoholic cirrhosis. , may develop into liver cancer.
3, drugs: Some drugs contain harmful ingredients, long-term use will have a cumulative effect, which may cause liver cancer.
4. Viral hepatitis: Viral hepatitis, especially hepatitis B, is an important cause of liver cancer. According to the survey, the incidence of liver cancer in patients with hepatitis B is dozens or even hundreds of times that of healthy people. Active prevention of hepatitis is very important to prevent the occurrence of liver cancer.
5. Liver cirrhosis: Clinical investigation shows that liver cirrhosis will generally develop into liver cancer, among which necrotizing cirrhosis is the largest, followed by posthepatitic cirrhosis, which also shows that hepatitis is closely related to liver cancer.
6. Chemicals: Some chemicals, such as nitroso compounds, can cause liver cancer, and these compounds can also cause other cancers. In addition, safrole and pesticides may cause liver cancer.
How long can you live after liver transplantation?
When the liver diseases caused by various reasons develop into life-threatening in the late stage, the diseased liver that has lost its function is removed by surgery, and then a healthy liver with vitality is implanted into the human body to save the lives of endangered patients. This process is liver transplantation, commonly known as? Change the liver? . At present, orthotopic liver transplantation has become the most effective method to treat end-stage liver disease. A considerable number of patients with liver cirrhosis need liver transplantation to save their lives. Because large-scale liver transplantation in China has not been carried out for a long time, people are afraid of liver transplantation, and many patients often have no choice but to do it when their lives are difficult to maintain. At this time, the best opportunity for liver transplantation has been missed, and the risk of operation is huge and the cost is doubled.
Before preparing for liver transplantation, patients with end-stage liver disease are most concerned about how long they can live after liver transplantation. This question cannot be answered in general. In western developed countries, the one-year survival rate after liver transplantation is >: 90%, and the five-year survival rate is 70-85%, which means that most patients can live healthily for a long time. The longest survival after liver transplantation has been more than 30 years, and a large number of patients have survived for more than 10 and 20 years, with good quality of life. Most of them can engage in normal social life and family life.
In recent years, some large medical centers in China have also carried out this work, and it has gradually become a routine clinical treatment. However, the survival time of patients with different conditions after liver transplantation is very different, the cost of operation itself and postoperative treatment is high, and the source of organ donors is seriously insufficient. Therefore, for patients with long-term survival and good quality of life after liver transplantation, we should correctly grasp the surgical indications and make use of limited resources.
Generally speaking, liver transplantation is suitable for the treatment of various acute liver failure, end-stage cirrhosis caused by chronic liver diseases, congenital metabolic diseases, hepatic vascular abnormalities and primary liver malignant tumors. It should be pointed out that with the continuous improvement of liver transplantation operation skills, the improvement of patient management before and after operation, and the emergence of new and more effective anti-rejection drugs and anti-hepatitis virus drugs, the survival time of liver transplantation patients will be further improved, and the research on liver transplantation has reached a higher level.
The Department of Liver Surgery of the First Affiliated Hospital of Harbin Medical University is the only medical center in Heilongjiang Province to carry out liver transplantation. At present, various liver transplantation operations, including living donor liver transplantation, have been carried out, and it is also one of the only six specialized hospitals for precision liver surgery in China, which is at an advanced level in the field of liver surgery. At present, our center has set up charitable rescue measures for liver transplantation, and patients are welcome to come for consultation and treatment.