A lot of patients produced disheartened mood after getting liver cancer and tumor, even sigh with sadness that one's destiny is not good. Actually, the destiny can be change, and it is in the control of one's own hand. However, how to change this misfortune? It is decided by the vigor from the patient's mind and the spirit of resisting with destiny. The sufferer should use this boldness of vision to change one's destiny, to write the history of conflicting with disease. It is an important internal factor, and any external factor can't change.

1.Where there is a will, there is a way

Where there is a will, there is a way. In another Chinese saying it is "no bravery, no achievement".

"Bravery" is the strong will to conquer the difficulties under great pressure. It's the conflict to pressure. It's the disdain to adversity. On the history, all the people, who gained great achievement, overcame various difficulties and persisted many years, and finally they succeeded.

To conquer the tumor is the same. From the opinion of medicine & philosophy, all the treatments to tumor is the external factor, while the confidence on preventing tumor, the belief on overcoming the tumor, the optimistic mind and the body resistance & recovery abilities are the internal factors. Traditional Chinese Medicine pays more attention on the internal factors and takes them as the key to prevent and treat the tumor, and they are the bases for disease getting better or worse. The external factors, including all the treatments and medicines, can function only by internal factors. Therefore, in the process of sufferer's fighting with tumor, sufferer himself or herself is the owner of his or her fate, and shouldn't only depend on a certain treatment or the doctor who fulfill the treatment. At the same time, sufferer shouldn't embrace anxious attitude, and also shouldn't hope to refresh in one morning and all the tumor cells disappear. When the tumor sufferer faces the aggravation, metastasis and spreading, he or she will experience the severer second and third strike. If the sufferer doesn't have the firm determination to fight with the fate and disease for a long period, he or she will definitely collapse once he or she meets the drawback. Nowadays, there are more and better treatments and medicines, and people become more dependant on them and weaken or even lose their strong will against the disease. So we emphasize again and again "Where there's a will, there is a way". The meaning is particularly profound.

In the recent process of people's struggle with tumor, the technique & effect of both the medicine treatment & physiotherapy are getting better and better on the view of all overall level of treatment. And the overall level of China's research & treatment are NOT inferior to the international level, even more advanced than the international level in a certain field.

The World Health Organization clearly pointed out that" Apply the modern medical knowledge and medical technique to treat all tumors, then 1/3 of the tumors can be prevented; 1/3 can be cured if they are early diagnosed; the other 1/3 can be alleviated the pain and life prolonged". With the development and progress of science, the efficient cure tumor rates are getting higher and higher. WTO predicted that in the early 21 century, mankind would conquer the cancer just like conquering the tubercle and other violent infectious diseases. In our country, the detection & treatment of the early tumor have exceeded the international level, such as the prevention and treatment in oesophagus cancer and cervix cancer. We also have made great breakthrough in the treatment for lung cancer. More and more sufferers survived 5--20 years. Many tumor sufferers and their relatives dare not to talk about the cancer. It has two main reasons. One is that the society & media propagate the definite death caused by cancer; the other is that people don't know the new progress and technique made in the tumor prevention and treatment. Therefore, many tumor sufferers and their relatives think that tumor is equivalent to death and tumor is unconquerable. The "will" is lost firstly before they fight with the tumor. This is quite false in fact. To treat the tumors just like start a battle, sufferers hardly realize that the brave soldier is definite to win and when two armies meet, the brave one wins eventually.  

2. Face the realities, and conquer the cancer bravely

In fact the tumor exists in everyone's body, the difference is that the tumor in health human body is a milligram tumor or even nanometer tumor, that is to say the tumor's physical volume is smaller than 100 milligrams in human body. At non-tumor surgical operation and other accidents operations, one or even more than one tumors smaller than 100 milligram have been found in the sufferers' organs and bellies, but certainly this kind of tumor is NOT harmful to the human body. When the person's mental state is overcast, suppress and in bad immune system & malfunctioned monitor system over a long period of time, this kind of tumor would appear the malignant proliferation and grows up, metastasis, forming the occupying-lesion. Therefore, the auspice of tumor is the tumor emotion. Whether in the find of the disease or the process of treatment, it's very important to conquer the tumor emotion and make firm determination & confidence to struggle with the tumor. Good emotion is the key point to cure tumor, so the first problem the sufferer faces is to control the emotion. It has been proved by the fact that optimism definitely leads to victory. The times exaltation of human body immunity can repress the growth of the tumor and make tumor cell conversed, while sorrow, frighten, fear etc., will further break the immunity function and the tumor cell would also excessively increases and the condition would be worsened. The pessimist emotion can cause the cancer, and the optimist emotion can cure the cancer, just like an old Chinese saying that " the water can float the boat, as well can capsize the boat ". Thus, the emotion is very important in tumor prevention and cure, even is a critical factor.

Compared to international technique & level of tumor treatment, the whole treatment level of China is superior in the normal treatment such as the surgical operation, chemotherapy, radiotherapy and biotherapy, especially the non-traumatic cure of the natural medicine. It's fairly superior of combining the traditional medical science with modern science technique, partial cure with the total body cure, internal use with outside use. These treatment methods can not only kill the growth of tumor cell, make it soften, contract and disappear, but also can increase people's immunity function. This non-traumatic treatment is the final target & pursue of both the doctors and sufferers. Now it is realized gradually, especially the application of various nanometer and gene technique. We believe that cancer is conquerable and human will conquer the tumor finally. And the target to refresh the tumor sufferers can be achieved definitely.

Certainly we must point out that even in the next century, serious cold turning to pneumonia will cause death, and not mention to tumor disease. It's impossible to cure all the tumor sufferers by a certain treatment or medicine. It is only on the aspect of tumor curing result statistic to show lower death rate and higher surviving rate. The individual difference exists forever, and only gradually science is perfect. Once living there will be the death, and having the life there will be the disease. Mankind is exactly to evolve in the process of this continuous conflict with disease.  

Liver is the largest gland inside the human body, and its functions include metabolism, secretion, egestion, biotransformation, digestion and so on.

Its main functions are as follows:

1 secreting bile: the liver cells secrete bile continuously, and the bile goes into the intestinal tract finally and promotes the digestion and absorption of the fat, and the absorption of the fat-soluble vitamins (vitamin A, D, E and K).

2 participating in saccharometabolism and maintaining the blood sugar concentration stable: lang=EN-US style='font-size:14.0pt;'> after meals, the concentration of the glucose from the intestinal tract to the blood rises, and at this time, the liver cells intake the glucose from the blood, and synthesize it into glycogen.

3 participating in protein metabolism: liver is the main area for protein (including structural proteins and plasma proteins) synthesis, and most (80%) of the absorbed amino acids by the alimentary tract are carried on to do synthesis, deoxidation and transamination functions in the liver.

4 participating in lipidic metabolism: liver plays an important role in the lipidic metabolisms such as the metabolism of digestion, absorption, disintegration, synthesis and transportation and so on.

5 participating in hormonic metabolism: hormone exerts its specific adjusting function, then disintegrates and converts, thus decreases or loses its activity, namely the hormonic inactivation.

6 the main area for biotransformation: biotransformation function is that non-nutritious matter or toxin through metabolism and transformation changes into the formation that can be easily ejected, thus they can be ejected outside the body easily, also named as detoxication.

7 Liver plays an important role in bilirubinic metabolism.

8 phagocytosis or immune functions: liver depends on the kupffer cells' phagocytosis function of the RES system, and expels the bacteria, pigment and other metabolic ingredients from the blood.

First of all, we must know what's tumor, tumor is an extraordinary accrmentition of a kind of cells. Compared with the normal cells, tumor cells have extraordinary structure, function and metabolism, and have the unusual proliferous ability, which is not coordinating with mechanism. Tumor includes benign tumor and malignant tumor. The malignant tumor, such as liver cancer, stomach cancer and lung cancer, is one of the main diseases threatening healthy of the human beings. The malignant tumor originating from the mesenchmal unepithelial tissues is called sarcoid.

Features of cancer cells include division continuously and disorderly, and also have invasion (infiltrating to nearby tissues) and metastasis. Cancer is a group of diseases, and its features are that the unusual cells grow losing control, and spread from the primary foci to other positions, and if this dissemination can't be controlled, it will invade critical organs to be prostration, and cause to death.  

According to tumors' biologic behavior and harm degree to humans' body, tumors can be divided into benign tumor, junctional tumor and malignant tumor.

1 benign tumor: it grows slowly, and presents dilatant expansion, and has clear boundaries and envelops; the differentiation of the tumor cells is well, and its color and texture is similar as the corresponding normal tissues, and all kinds of cell organs, membrane structures and cell courses have no great variation; it usually has no relapse, or relapse rarely, and no metastasis, and recovers well.

2 malignant tumor: it grows rapidly, and presents infiltrating development, and can destroys near tissues, and has no envelops or has false envelops; the differentiation of tumor cells is poor, and tissues and cells are different completely with normal corresponding tissues, and presents allotropy, and ranks disorderly; karyon formation is not regular, and nucleolus enlarges, and karyomitosis increases and there appears pathologic karyomitosis; the metabolic function of the tumor is not normal, and the nuclear metabolism is prosperous, and the enzymic spectrum and inheritance changes. Tumors infiltrate widely, and they are often relapsing, and easily metastasis threatening the life.

3 junctional tumor: the boundary between benign tumor and malignant tumor is not clear, and the transferring course from benign tumor to malignant is gradually, so there are some juctional tumors between the benign and the malignant.

4 precancerous lesion: it refers to the diseases that may transfer into cancers but not certain to be cancers.

5 cancer in situ: cancer cells are still limited in endepidermis, and doesn't penetrate basement membrane, which is integrated.

1.      According to the tumors' primary positions, liver cancers can be divided into the primary and the secondary. The primary refers to the tumor that occurs from the liver cells or the biliary duct cells inside the liver. The secondary, also called metastasis liver cancer, refers to tumors from other organs of the whole body transferring to liver.

2.      Primary liver cancer can be divided into the liver cells type, the biliary duct cells type and mixed type according to cell types.

3.      According to clinical appearances, it can be divided into the simple type, the sclerosing type and the inflammatory type.

4.      According to the clinical symptoms, it can be divided into the sub-clinical type and the clinical type.

5.      According to the size of tumors' tubercles, it can be divided into the small type, the big type and the huge type.

Invading is the specific feature of malignant tumors, and it refers to cancer cells leaving the primary foci and invading near tissues, and going on proliferating and growing at this place, namely invasion. It can be divided into primary invasion and secondary invasion. The primary invasion is that primary foci invade to near tissues. The secondary invasion is that cancer cells leave primary foci for far away organs, and form new metastasis foci then transfer to other near tissues from the metastasis foci.

Metastasis refers to tumor cells transferring and effusing from primary foci to secondary positions, where they form metastasis foci (primary tumor). Cancer cells break away from primary tumor, and invade near tissues, and invade lymphatic vessels, blood vessels and body cavity. Some tumor cells are brought to another far position or organ by lymph or blood stream, and they go on existing and living after interactions with host tissues, and forming the same type of secondary tumor (metastasis foci) as the primary one.

Liver cancer is one of the ten most common malignant diseases, it is very important for discovering early liver cancer patients to ascertain the highest dangerous people, but what kind of people take higher risk of getting liver cancer?

1. Age: generally speaking, people group above 35 years old should be noticed. Much investment material manifests that at the areas where has a high liver cancer rate, the age group below 40 years old has a high morbidity rate. At the areas where has light epidemic degree, the age group above 60 years old has a high morbidity rate.

2. Sex: it is nearly at all areas that male liver patients are more than female ones, the ratio between man and woman is 2:1, and at the hyperendemic area of liver cancer, the ratio is above 3:1. The reason of gender differences that there has a high liver cells cancer morbidity rate in males is not clear now, and can be explained by that the males easier to catch, or inheritance factors or males more relating with the liver cancer causing environment, for example, most of the hepatitis B patients are males, and most alcoholic are males.

3. Positive HbsAg and chronic liver disease over five years: HBV has close and specific causality with liver cancer. HBV has been well-known cancer-causing matter only inferior to tobacco. All HbsAg carriers will ultimately catch liver cancer, if they can live enough long, and are not caused to death by other reasons. More than 40% continuous infectious patients are caused to death by liver cancer or hepatocirrhosis after being adults.

4. Liver cancer family history: there is researching result that some inheriting defect patients take the risk of liver cancer increasingly. There is family accumulation of liver cancer.

5. Alcoholic: alcohol is important factor to cause chronic liver disease, and alcohol is related with the increasing risk of liver cancer.

Paying attention to the fixed check for dangerous people is beneficial to discover, diagnose and cure liver cancer early.

Primary liver cancer originates from the liver or biliary duct system inside the liver, and most are liver cells cancers in China. Liver cancer has short disease period, great harm and spread widely, and is one of the malignant tumors that do harm to humans' life and healthy. We applied unified investigating method of reviewing death conditions in China, and have cleared about the distributing conditions of liver cancer in China, and the average liver cancer death rate of males is 14.25/100thousand, for females, the rate is 5.6/100thousand. 100thousand people die of liver cancer in our country every year, the male death rate of liver cancer ranks third place of all kinds of malignant tumors, only inferior to stomach cancer and esophageal cancer; the male death rate ranks the fourth place only inferior to stomach cancer, cervix cancer and esophageal cancer.

According to the clinical symptoms, periods and pathologic changes of patients, to divide periods and types of liver cancer is advantageous for studying physiologic and pathologic changes and evaluating treatment effects. So it can guide to take reasonable and effective measures for different types of cases.

1.     According to clinical symptoms: it can be divided into common type, concealed type, feverish type, acute abdomen type, metastasis type, hepatitis type and cholestasis type. Most is common type clinically. According to differences of clinical symptoms, it can be sub-divided into hepatomegaly type, hepatic abscess type, hepatocirrhosis type, obstructed jaundice type, intra-abdominal hemorrhage type, hypoglycemic type, cholecystitis and cholelithiasis type, chronic hepatitis type, intra-abdominal cyst type, diffuse carcinosarcoma type, leukemoid type, paraplegic type etc.

2.     According to the level of AFP: ⅠLevel of AFP is above 1000ug/L while at the first diagnosis, after that it is 1000ug/L when checking every week.ⅡLevel of AFP is above 1000~2000ug/L at the first diagnosis, and it rises 1000ug/L every 3~4 months, which is very slowly. Ⅲ Level of AFP is below 200ug/L at the first diagnosis, and it has no great changes. The higher the level is, the quicker the disease develops, the less opportunities of having operations, the shorter patients lives.

3.     There are three types and three periods according to present standard:

Pure type: there are no obvious hepatocirrhosis clinically.

Cirrhotic type: obvious hepatocirrhosis clinically or through lab test results.

Inflammatory type: the disease develops quickly with continuous cancerous calor fervens or the GPT rises for one time.

Ⅰperiod: there are no obvious symptoms of liver cancer.

Ⅱperiod: exceeding the standard ofⅠperiod, but has no evidence ofⅡperiod.

Ⅲ period: there is cachexia, jaundice or distant metastasis.

Primary liver cancer is concealing, and it has no obvious symptoms at early period, once there are clinical symptoms, it has developed to medium or later period. It bring many difficulties to diagnose liver cancer, because it is the variety of synthesizing hepatocirrhosis, tumor metastasis etc.

Liver pains is the first symptom of liver cancer, then they are burbulence, abdominal tumor, inappetence, losing weight, diarrhea and fever etc, and some may have transferring foci. For example, there are hemoptysis and chest pains if liver cancer transfers to lung and pleura, and there are waist and back pains and no lying down if transferring to pancreatic gland. Liver pains, which is a half of all first symptoms, is the most common and distinctive, and has certain characters that may be paid attention to:①most pains are continuous; Some are interrupted, and it cannot be relaxed after rest.②slight pains at early period, and stitch, bulging pains and agony at medium or later period.③pains intensify after working or at night, and pain killer has no obvious effect.④pains may relate with posture, and left clinostatism is more obvious.⑤pain places are related with tumors' places in the liver. For example, liver cancer locating right lobe, there are mainly upper right belly or right costa, and there is lower xiphoid pains mainly for left lobe liver cancer; if some liver nodule crack, there are acute agony spreading to be whole belly cancer with bloody ascites and shock.

Besides liver pains, other symptoms have no specifics. Some individuals may have hypoglycemia, scalp tumor and edema of lower limbs, which seems no relations with liver diseases. So for high morbidity rate people, such as liver cancer family, hepatitis B, hepatitis C, cirrhosis and people in high morbidity rate area, should check to be certain or expel liver cancer, if having above symptoms, to avoid delaying treatment.

1.     Abdominal pains: abdominal pain is the most common symptom of suspected people. Pains locate at right costa or epigastrium, some at left costa, hypogastrium and back, but seldom to right shoulder. Most pains are continuous blunt pains. Liver cancer should be suspected if cirrhosis patients have epigastric pains of no reason.

2.     Abdominal tumor: abdominal pains can attract people to pay attention to epigastric tumors, but some patients only have tumors but no pains.

3.     Alimentary tract symptoms: inappetence, disgusting, burbulence, and vomitive. And inappetence and burbulence are most common. Some have hematemesis and black stool caused by alimentary tract hemorrhage.

4.     hypodynamia, weak and emaciation: it is marantic appearance of liver cancer, and not obvious at early period, so is not paid attention to, but some develop while patients are hyodynamic or losing weight in a short time. With development of disease, hypodynamia and emaciation increase progressively. At later period, fierce agony, much ascites, inappetence and many complicated symptoms cause prostration and present cachexia.

5.     Others: feverish, hemorrhage trend, bone pains and hemoptysis are also symptoms of liver cancer patients.

Small liver cancer also is called early liver cancer, and there is no unified standard internationally. Generally it refers to the tumor, the diameter of which is less than 3cm. The standard of China Pathologic Synergic Group is as follows: ①the diameter of single cancer tubercle or the sum diameter of two cancer foci is equal or less than 3cm, more than three cancer foci is not included in small liver cancer.②No symptoms and AFP can be positive.③after operative resection, AFP changes into negative. According to medium or later period liver cancer, small liver cancer has smaller tumor, clear boundary, and form a certain envelop. Fibrous envelop restricts tumors' development at a certain degree, but it cannot prevent cancers development, so it is common that envelopes are invaded. Tumor whose diameter only is 8cm may invade envelop, and many small liver cancer has metastasis at early period.

Sub-clinical liver cancer is also called liver cancer of no symptom, which refers to liver cancer through AFP or image check to diagnose. Most of them are small liver cancer or early liver cancer, but some may big or gigantic liver cancer that cannot be cut by operation.

1. Massive check for liver cancer: when rechecking suspected people or massive check, discover small liver cancer, or early liver cancer, discovering methods are as follows: ①liver cancer serum symbols: AFP, γ—GT, GGT, variant alkaline, extraordinary prothrombin.②image check: B ultrasonography, CT check, MAP and hepatic artery graphy.

2. New small liver cancer after operative resection: relapsing rate is very high after operative resection, and most of them are relapses inside liver. Check AFP in fixed period, B ultrasonic and CT check can discover relapsing liver cancer.

3. Achieving small liver cancer after comprehensive treatment to big ones: comprehensive treatment methods to liver cancer are chemotherapeutic embolism of hepatic artery, chemotherapy, radiotherapy and injecting dehydrated alcohol inside the tumor, if tumor is dilatant type and has complete envelop, artery embolism is more effective. Under the guidance of B ultrasonic, injecting dehydrated alcohol inside the tumor can make the tumor tissues to be coagulation and necrosis.

1. Blood channel metastasis: it is the most common way, and cancer cell is easy to invade portal vein and hepatic veins, which can happen at early stage, cancers' infiltration to veins is the pathologic basis of cancer metastasis inside the liver. If the sinusoid is little and the connective tissue is rich, it is less common to occur metastasis inside the liver.

2. Lymph channels metastasis: it is also common way, most transfer to hepatic port lymph nodes, and for serious patients, it may transfers to peripancreatic, retroperitoneal, para-aortic field and lymph nodes of the collar bone. And hepatic port lymph node is most common. Biliary duct lymphatic vessel metastasis is more common than serum metastasis.

3. Spreading, infiltrating or planting metastasis: peritoneal metastasis is common when liver cancer transfers to hepatic envelop, and cancer cells can infiltrate peritoneum directly or fall off to cause planting metastasis, peritoneum cancer and bloody ascites. Liver cancer can infiltrate hepatic envelop to cause pains, to form partial cancer nodule, and the nodule cracking can cause serious hemorrhage. Liver cancer doesn't transfer to interseptum, right chest cavity, capsule of heart, great omentum of anterior abdomen, stomach, intestines and ovary.

The histology of metastasis liver cancer is similar with primary tumor.

1. Lung metastasis: it has the highest transferring rate of the distant metastasis, and is about 70% of all, and lung metastasis is caused by small carcinomatous embolism, and its transferring foci usually are very smaller, and the diameter is not longer than 1cm.

There are coughing, chest pains, sputum cruentum, hemoptysis etc. some times they are the first symptoms of lung metastasis. But there are also some patients having no special symptoms until later period to have coughing and hemoptysis. For pleurae metastasis, there are chest pains and dropsy of chest. There are three types of transferring foci inside the lung: nodular type, diffuse type and giant chunk type, and nodular type is the most common type clinically.

2. Bone metastasis: bone metastasis is very common in primary liver cancer, and it is about 11% of all the metastasis. Spondylous bone, flank bone, haunch bone, costal bone metastasis are the most common, sometimes sternal bone, collarbone and cranial bone metastasis occur, especially chest bone and vertebrae lumbales. There are obvious partial tenderness, nerve compression or pathologic fracture.

3. Intra-cranial metastasis: when liver cancer transfers to brain, there are neural localization symptoms such as headache, disgusted, vomitive and poor member activity

4. Others: when transferring to peritoneum, there are abdominal pains and bloody ascites, when to lymph nodes, there is painless swollen lymph node. When to skin and kidney, there are some related symptoms.

We should pay attention to discover and cure metastasis foci in the course of curing liver cancer, sometimes symptoms caused by metastasis foci may the first symptom of liver cancer.

Liver cancer is not easy to be discovered at early period, the reasons are as follows:

1. Concealed: early liver cancer has no obvious symptoms and it is not positive through common physical check.

2. Variety and no specifics of early liver cancer: early liver cancer usually has slight symptoms, various and no specifics.

3. Concealed by background diseases: as liver cancer is various, some academics divided it into nine types: common type, cirrhosis type, latent type, feverish type, metastasis type, hepatitis type, acute abdomen type and cholestasis type. We can see that clinical performance of liver cancer is complicated and has no specifics, if the clinical doctor has no enough patients, diagnosis may be delayed. Poor medical conditions and diagnosing methods is also the reason that liver cancer cannot be diagnosed in time at some remote regions.

5. Weak healthy maintenance consciousness: at present, fixed-time and regular massive check cannot be done, so natural individuals especially for people above 35 years old with chronic liver diseases such as chronic hepatitis and hepatocirrhosis, should reinforce healthy maintenance and checking consciousness, and achieve the purpose of discovering, diagnosing and curing early.

1. Liver cells cancer: it refers to the liver cancer originating from liver cells, and it is related with HBV, hepatocirrhosis and aflatoxin.

2. Bile duct cells cancer: it is a malignant tumor originating from epithelium of bile duct inside liver, and can be divided into three types: giant chunk type, nodular type and diffuse type, and giant chunk type is more common. It is also divided into two types: tumor type and infiltrating type.

3. Bile duct cancer of hepatic port: it is a primary malignant bile duct tumor.

4. Secondary liver cancer: it is also called metastasis liver cancer. It is formed by tumors transferring to liver from other organs of the body.

5. FCL: it is a special type of liver cancer, and occurs at the liver without cirrhosis.

6.Hepatic angiosarcoma: it is also called endothelioma angiomatosum, and it is a high malignant tumor.

7.Hepatic epithelioid hemangioendotheliosarcoma: the morbidity age is 20-80 years old, and average age is 50 years old, and two thirds are women.

8.Undifferentiated hepatic angiosarcoma: it is also called primary angiosarcoma, and high malignant tumor, and there are more children to catch it.

9. Primary hepatic lymphoma is rare.

10.Others: hepatic fibrous angiosarcoma, leiomyosarcoma, malignant hepatic fibrohistiocytic tumor, hepatic melanoma, malignant hepatic trophoblastic tumor, primary yolk sac carcinoma are also tumors occurring in liver, but they are very rare.

Most liver tumors are malignant ones, and benign ones are rare, and some benign ones cancerous tumors, and can be divided into six parts:

1.Liver cells type: it includes nodular regenerative hyperplasia, hepatocellular adenoma, focal nodular hyperplasia.

2.Bile duct cell type: it includes bile tract adenoma, tiny hamartoma of hepatic duct, bile duct cystadenoma, bile duct papilloma.

3. Blood vessel type: it includes blood vessel tumors, infant hemangioendotheliosarcoma, hereditary hemorrhage telangiectasia, lymphatic duct adenoma and so on.

4. Mesenchyme type: it includes leiomyosarcoma, fatty tumor, pulpal fatty tumor, vascular fatty leiomyoma, false fatty tumor, fibrous mesothelium tumor and so on.

5. Mesenchyme—epithelium mixed type: it includes mesenchyme hamartoma, benign dysembryoma and so on.

6. Others: such as adrenocortical rest tumor, inflammatory false tumor, focal fatty change and so on.

1. Hepatic nodular regenerative hyperplasia: it is also called hepatic cell gland tumor, hepatic diffuse nodular hyperplasia and so on.

2. Hepatic focal nodular hyperplasia: it is not tumor type, and most are solitary tubercles, and the boundary of foci is clear, and has no envelop, and often mixed with other occupying lesions.

3. Hepatic cell gland tumor: it is short for hepatic gland tumor, and a benign gland tumor of women, and benign hyperplasia of hepatic cells.

4. Hepatic angiomatosis: it is the most common one of benign tumors.

5. Hepatic fatty tumor: it is rare clinical and can occurs at any age, and more for adults.

6.     Others: hepatic dysembryoma, mesenchyme hamartoma, inflammatory false tumor, leiomyosarcoma, fibrous mesothelium tumor, peliosis of liver are also benign tumors of liver.

“Three early” should be promoted not only for natural people or dangerous people, namely early discovering, early diagnosing and early treatment. We should carry out preventing treatment, and decrease the population of whom the HbsAg and AFP of lower titer are continuous positive.

1.Water: drink well water, and stop drinking pond and ditch water.

2.Crops: take care of crops, prevent mildew, and eliminating toxin is an important measure to prevent liver cancer.

3.Preventing hepatitis: HB and HC have close relations with liver cancer.

4.Others: prevent pesticides poisoning and environmental pollution, and reduce drinking alcohol.

Long period drinking alcohol can cause chronic alcoholic hepatitis, even to be alcoholic hepatocirrhosis. The harm that alcohol does to liver are mainly that direct harm of the ethylaldehyde, which is intermediate metabolite, to the liver and long time nutritious disturbance caused by drinking alcohol. So liver's resistance against some toxins is lowered.

According to some research, drinking alcohol can increase the risk of catching liver cancer. The more alcohol a person drinks, the longer time a person has begun for, the higher risk he takes of getting liver cancer.

So excessive drinking can increase the risk of catching liver cancer. To prevent and reduce liver cancer and disease, we should control drinking.

The main noxa of liver cancer may be HV. Different HV has different relations with liver cancer.

1.HAV: it can be cured well, and has a bright future, and it seldom causes cirrhosis and liver cancer

2.HBV: HBV is the main noxa of liver cancer in developing country.

3. HCV: it is the main noxa of liver cancer in developed country.

In a word, according to research, hepatitis (mainly HB and HC) is the main noxa of liver cancer, and has close relations with liver cancer. Preventing HV infection is an important measure of preventing liver cancer.

Liver cancer is the result of multiple factors, steps, genes and mutations. It is the result of the multiple environmental factors interacting with multiple hereditary factors. The occurrence of liver cancer includes two steps at least. The first one is “generative stage”, it is a rapid and irreversible course caused by the cancer-causing preparation, which affects DNA's function and structure; the second one is “promoting stage”, it is slow, no specifics, and reversible, which changes expression of cell' inherent information. Some environmental matter can be cancer causing or causing-promoting, and make liver cells cancerous in the two stages.

The environmental factors relating with liver cancer are as follows: HV, chemical factors, water pollution, alcohol and tobacco, trace elements, sex hormone, parasite, inheritable disease, related diseases (self immune disease, postcaval membranous closure, pylephlebitis, cholangitis, calculus) iatrogenic factors and psycosocial factors.

Residents drinking turbid water have higher rate of catching liver cancer and dying of it; residents drinking clean water have lower rate; if changing to drink clean water, liver cancer morbidity rate is lowered. It manifests that liver cancer has certain relations with water pollution.

Thus, improving water quality and supplying proper selenium can lower catching liver cancer's rate.

Nitrosamine substances belong to nitrosate compound, and kinds of nitrosamine matters have wide cancer-causing ability, and can induce cancer of many organs, and some of them have strong cancer causing ability, many kinds nitrosamine compound can cause liver cancer, and do great harm to humans.

There are two ways for nitrosate compound to enter into body:

1.Eating formed nitrosate compound: much food includes nitrosamine matter, which is generally very little, but in some cases, may produces much nitrosamine, such as fried salty meat.

2.Eating protonitrate and nitrosate matter at the same time: protonitrate may exist in: ①protonitrate is main additive of producing meat, which includes much protonitrate.②nitrate can be restored into protonitrate. There are protonitrate of high concentration in water, soil and sewer③ many microbes in intestines and saliva can restored nitrate into protonitrate.

AFT is poisonous metabolite that the toxingenic strain of aspergillus flavus and aspergillus parasiticus produced when growing, belonging to organic chemical cancer causing matter. AFT is poisonous and cancer causing.

According to research, AFT not only can cause liver cancer directly, but also can destroy immune supervising system of mechanism, so small malignant tumor foci cannot be discovered and eliminated, and immunity of cells is restrained, and Hepatitis carrying rate increases.

Toxicity and cancer causing ability of AFT is the strongest of all the poisons, and should belongs to super deleterious grade, and do harm to animals' liver. ①do harm to liver cells;②liver cells have degeneration and necrosis, and neogenesis continuously, and form regenerative nodule under the action of toxins;③there are hyperplasis of bile duct oval cells.④there are seldom cirrhosis.

Biochemical action of AFT is mainly restraining polymerase of RHN, and preventing the synthesis of ribosome and nidal RHN; restrain the precursor of DNA, change the template property, interfere with the transcription of DNA; restrain synthesis of proteins.

The course of AFT causing liver cancer can be divided into several periods:①there are hydropic degeneration of liver cells;②there are proliferative basophil cells, which can exist singly, or exist with hydropic degeneration, and many enzymes in the basophil cells lack activity, such as glucose-6-phosphatase, alkaline phosphatase and succinate dehydrogenase;③there is nodular hyperplasia of parenchymal cells;④there are mutation cells;⑤form liver cancer.

For a long time, people think that “once to be cancer cells, be cancer cells for ever”, that is to say, it is not possible for malignant tumor cells to reverse into normal cells. So to cure malignant tumor, we adopt operation, radiotherapy and chemotherapy to eliminate tumor cells, but never consider the method that reversing tumor cells into normal ones. Under certain degrees, we can reverse malignant tumor cells into normal ones with the help of differentiating inductor. We have certain treatment effects in the research of kinds of tumors (liver cells cancer, colon cancer, mammary gland cancer, lung cancer and melanoma).

1.Related concept: tumor reversion refers to that malignant tumor cells reverse, differentiate and evolve into normal ones with the help of some differentiating inductor. The reversion refers to restraining the proliferation of cancer cells, and promoting them into normal ones.

2.Possiblity of reversion: many kinds of cancer cells reverse into normal ones or nearly normal ones under differentiating inductor. Leukemic cells also have this trend.

3.Common differentiating inductor: differentiating inductor is a necessary condition for the tumor reversion, and can be divided into endogenous and exogenous two types.

4.Liver cancer cells reversion: according to research of 70s of the 20^th century, liver cancer cells strain of humans' can be differentiated into mature liver cells that can synthesize albumin with the existence of RNA of mouse liver.

With the existence of RA and IRA with cAMP or selenite sodium, liver cells strains can have certain reversions, the formation, function and embolism of cells is similar with normal cells.

Tumor has close relations with diet and nutrition, and diet is auxiliary to cure tumor.

Early liver cancer patients should eat food of nutritive blood. Patients in recovering period should eat food of adjusting the stomach and spleen, and strengthening anti-cancer ability of mechanism, and reducing metastasis and relapse.

Disgusted and vomiting can chew ginger. Patients in late period should select all kinds of food with enough nutrition under the premise of digesting and absorbing.

Liver cancer patients shouldn't drink alcohol, and shouldn't eat chili, greasy and oily food, and hard food. If having ascites, the intake quantity of salt should be restricted.

They have close relations:

1.Hepatocirrhosis combined liver cancer: it has high morbidity rate in our country and other higher occurring rate areas of liver cancer, and takes 40%. And HB can develop into liver cancer through hepatocirrhosis or directly. HB is not only the noxa of hepatocirrhosis, but also of liver cancer.

Hepatocirrhosis is not paralleling with liver cancer, in some high rate of cirrhosis, liver cancer rate is not high. This may relate with the types of cirrhosis. 40%~50% cirrhosis is nodular type, and only 10% is small nodular type, so great nodular type cirrhosis has closer relations with liver cancer.

2.Liver cancer combined cirrhosis: its rate is 50%~90%, and 70%~85% in China, and 77% in England, and 89.2% in USA.

3.Hepatocirrhosis and liver cancer metastasis: liver cancer without cirrhosis has a higher metastasis rate, whereas, a lower rate.

4.Degrees of hepatocirrhosis: hepatocirrhosis supply conditions for liver cancer, and development of liver cancer increased the degrees of hepatocirrhosis, and intrahepatic circulation obstacle and biliary blockage caused by tumor can be factors of promoting cirrhosis.

5.Noxa types: Hepatitis cirrhosis has the highest morbidity rate, and trophism and alcoholic cirrhosis is secondary. And the opportunity of hepatitis cirrhosis developing into liver cancer is more than other types.

With the development of science, people have a further recognition with diseases. Metal factors are emphasized in curing the diseases.

Mental activities include recognizing activity, emotional activity and will activity. Mental changes always with physiologic and biochemical respects changing. Adjusting and controlling one's mental condition is important for one's health.

Poor mental conditions can affect the immunity of mechanism, and descent immune supervision functions, and it is easy for tumor to develop.

We should give correct mental support to malignant tumor patients, and make them open, broad mind, strong will and optimistic, and make them to be confident of struggling with diseases.

Liver cancer is well known to be a physical and mental disease, and its occurrence and development has close relations with psychology and society. The psychological conditions of liver cancer patients are very complicated, and to know the patients' metal conditions and to give correct support to patients is advantageous to improve quality of patients' life.

1.Doubtful period: before diagnosed as liver cancer, patients have special anxiety, and are shocked and suspected to the diagnosis, once to be diagnosed, they suspected if it is correct, and required recheck repeatedly, and hoped to overturn the diagnosis, and evade the fact.

2.Frightened period: when accepting the diagnosing result, patients are very frightened and anxious. Extroverted may cry out loudly, and eat and drink less; introverted may ask other to get proof. Patients are afraid of death, and concern about relatives, and need pity and care from others. At this time, we should give them more care, and help them face the reality, and do positive treatment.

3.Pessimistic period: when knowing of getting liver cancer, patients may be pessimistic and disappointed, for one hand, yearn for the past, and never lay down kinds of problems. For the other hand, they are eager to arranging and planning limited life, but seldom consider for the treatment. At this time, the mental activity of patients is very complicated, and appears that disappointment is more expectation, and death arrangement is more than living plan. Few patients can work out definite future.

4.Acceptable period: after a period of treatment, patients accept the state at present, and accept that they themselves are “the role of liver cancer patients” finally. Patients are calm because that they have certain arrangement for their life and work. And they also appear to accept treatment, and give full expectation to kinds of treatments.

5.Disappointed and optimistic period: after operation, radiotherapy and chemotherapy, patients not only have inconvenience in daily life, but also bear great sufferings in mental. Because of no obvious effect, weak body, heavy economic burden and sufferings, patients always have negative and disappointed psychology. A few may optimistic of obvious effect.

When people are old, mechanic functions of the body become ageing, and they know that death and ageing irresistible natural law more, and more and more near to ultimate stage of life with aging, once getting liver cancer, they are more afraid of death.

Because of poor health of old people, they always lose care ability for themselves, in addition to the disappointment caused by retirement, and life dependency reinforced. They have the mental features as follows:

1.Fear psychology: when old people get liver cancer, they are more and more afraid of death, some may speak it out, and some may put at the bottom of heart. They want to their diseases from others' behavior and conversation; they consider hardly for good prescription, and are afraid of treatment effect. If the disease course is long, patients may be gloomy, disappointed, lonely and eager to get care and comfort from others especially their relatives.

2.Self-certer: after getting liver cancer, old people think that everything and every related individual exist from their benefits. No matter for society or family, they contributed a lot, so they think that their children, sisters and brothers, leader and colleagues should care for them carefully from every respect. If not satisfied, they think subjectively that they were abandoned regardless of their contributions. They always complaint and lose their temper, which is disadvantageous for treatment.

3.Dependency: old people have dependency after getting diseases similar to children. They lose confidence and cry because that they cannot care for themselves, and bad treatment effect. And old people have strong self-respect esteem, and require to be respected.

According the mental features of old people, relatives and society should give them special care. We should respect and love old people, and improve their life quality.

Later liver cancer patients not only suffer physical sufferings, but also feel death coming mentally, and they experience the course of denying, sadness and acceptance to treat death.

Everyone's attitudes for death have close relations with characters, educational level and world outlook. For later patients on the brink of death, we should give our enthusiasm, patients and love to them, help them to spend their last stage of life. This is the humanism requiring us to do.

Clinical symptoms of liver cancer patients are various, except common symptoms of liver pains, burbulence and hypodynamia and so on, there are also some rare symptoms that clinical doctors should pay attention to:

1.Jaundice: it is not a common but important symptom.

2.Acute abdominal pains: burst abdominal agony or acute abdominal pains are the first symptoms of a few patients, and patients present wooden belly, pale face, cold limbs, fast heart rate, blood pressure descending even shock.

3.Hematemesis: liver cancer patients may have hematemesis and black stool, and it is more common for patients with hepatocirrhosis.

4.Bone pains: bone pains may the single or first symptom of a few patients. Bone metastasis of liver cancer has a high transferring rate of 20%, and the rate of bone pains is 3%~12%, and bone metastasis may be solitary or multiple.

5.Acute symptoms of the respiratory tract: for example, multiple lung metastasis appears dyspnea, cough and hemoptysis.

6.Malposed hormones syndrome: some patients have the malposed hormones syndrome of erythremia and hypoglycemia.

If having intra-cranial or intra-vertebral canal metastasis, there are headaches, paraplegic or localizing symptoms of nerve systems.

Except obvious hepatomegaly and transferring foci, the symptoms of primary liver cancer is similar with the symptoms of the hepatocirrhosis, and hepatomegaly is the most common, and occupies 91%~98.5%.

1.Hepatomegaly: it is the main symptom, and intumesce is very obvious, and even exceeds the umbilicus, and on the surface of the liver, there is nodular or great chunk apophysis, which is hard with slight tenderness.

2.Jecoral vascular murmur: it hints existing tumors, and the rate is 0.33%~29%

3.Jaundice: the rate 14%~44%, and patients with clinical hepatocirrhosis are more easy to get jaundice, and it can be liver cells jaundice, or obstructed jaundice.

4.Ascites: it is the common symptom of later liver cancer, and the morbidity rate of white people is a little higher than black and oriental people.

5.Splenomegaly: its morbidity rate is 48%, and 7%~38% in China.

6.Chronic liver disease: for patients with hepatocirrhosis, their chronic liver disease is distinctive.

7.Fever: liver cancer should be considered if having continuous fever of no reasons.

8.Muscular emaciation: it is very obvious when patients start being hospital, especially for rapid growing giant liver tumors.

9.Budd-Chiari syndrome: when liver cancer transfers to portal vein and hepatic vein, carcinomatous embolization can be formed, and blocks the hepatic vein. There are intumesces, ascites, dropsy of lower limb and so on.

10.Transfering foci: intra-liver metastasis of liver cancer can cause hepatomegaly presenting multiple nodules or tumors.

Pains are common symptoms of liver cancer, and 90% of liver cancer patients have pains, though different degrees.

1.Acute pains: they appear in the course of harmful diagnosis or anti-cancer treatment.

2.Chronic pains: first, when acute pains treatment is fail; second, progressive development can cause pains.

3.Later period pains: caused by secondary infection.

1.Liver cancer grows quickly, which makes the tension of the envelop increase.

2.Cancerous tumor invades liver's envelop or peripheral such as angioneurotic receptor.

3.Cancerous tubercle breaks.

4.Cancerous embolism obstructs or tumor invades portal vein, hepatic vein, or other blood vessels, causing tissue congestion or ischemia.

5.Tumor metastasis such as abdominal membrane or bone metastasis, can cause pains of responsible places

6.Secondary infections such as celiac infection, bed sore and so on.

7.Mental factors and other concomitant diseases that have no relations with tumor such as titanic cervical arthritis.

For liver cancer patients, especially giant liver cancer, if having epigastric pains, and spread to the whole belly rapidly, having tenderness or rebound tenderness with bloody ascites or low blood pressure even shock, spontaneous clastic hemorrhage of liver cancer should be considered. Spontaneous clastic hemorrhage of liver cancer has a high death rate and grows rapidly, so it should be dealt with positively.

Nodular disruptive hemorrhage of liver cancer is a common complicated symptom of liver cancer, and also an important death reason of liver cancer. Because of direct invasion of the tumor, venous vessels become obstructed, intravenous tension of the tumor increases, and the center of tumor necrosis appears, so peripheral tissues of the necrosis are fragile and easy to be disruptive; high portal pressure of hepatocirrhosis is also an important factor, portal veins nearby tumor have rami communicantes with hepatic artery, with the increasing pressure of the portal veins, the blood vessel is becoming thinner and thinner, and disruptive hemorrhage of cancer nodule can be caused by slight injuries or sudden increasing of intra-abdominal pressure.

Clinically besides hepatic pains, there is also rapid hemorrhage, the whole belly pains, tenderness of the whole belly, rebound tenderness, bloody fluid of celiocentesis. At the same time, there are also cold limbs, low blood pressure. For serious ones, there is hemorrhage shock or death.

1.Inappetence: because the tumor increasing compresses gastrointestinal tract, also with chronic liver disease, hepatic liver function damaged and mental factors.

2.Burbulence: epigastric burbulence has relation with that rapid growing tumor affects the gastrointestinal vermiculation. The whole belly burbulence, besides the above reasons, has relations with gastrointestinal flatulence and ascites caused by malabsorption.

3.Diarrhea: gastrointestinal function disturbance is caused by tumor growing, liver function damaged and digestive and absorbing function disturbance.

4.Hematemesis and black stool: hematemesis is caused by high portal pressure, esophageal fundic varix and rupture, and acute membranous disease of stomach, which caused by liver cancer with hepatocirrhosis. Black stool is caused by portal hyperbaric stomach disease and ulcer of alimentary tract.

For liver cancer patients, fever is common, and fever can be caused by infection and other factors. But there is continuous fever of no reasons for some patients.

1.Tumor grows quickly, compresses blood vessels, and causes ischemia and necrosis of cancer tissues. Necrosis matter is absorbed, and pyretogen into the circulation causes fever.

2.Tumor growing compresses bile duct, and causes bile flowing obstructed, and secondary choleric system infection.

3.Other systems infections are easy to be accompanied with because of poor resistance ability.

4.The 2-5-Biaoyixiong Tong inside the patients' body with liver cancer cannot associate with glucuronate, and causes fever.

5.Because of poor liver function, cholesterol cannot be degraded into cholic acid, but into right cholic acid, which causes fever.

Jaundice appears at later period of liver cancer, and the rate is 20%. Patients with hepatocirrhosis are easier to get jaundice.

Jaundice can be divided into obstructive jaundice or hepatocellular jaundice. The mechanism is as follows:

1.Tumor compresses or invades main bile duct, and obstructs the bilious egestion, and causes obstructive jaundice.

2.Hepatic portal metastasis and malignant lymph node intumesce compress choledochus, and cause obstructive jaundice.

3.Tumor invades small bile ducts widely, and tumor tissues grow into main bile ducts along small bile ducts, and cause obstructive jaundice.

4. Malignant tumor necrosis tissues nearby the main bile ducts fall off, and go into the bile ducts, and bile ducts bleed, and they cause obstructive jaundice.

5.Hepatic tissues are invaded by tumor widely, with hepatocirrhosis, chronic hepatitis, and liver functions damaged, and cause hepatocellular jaundice.

1.Skin's color is dark yellow, yellow green or green brown.

2.There is skin titillation, because bile duct is blocked, and bile salts return to systemic circulation, and stimulate cutaneous peripheral teleneuron.

3.Bilirubin increases in the serum, mainly direct bilirubin, transaminase is normal or increases, GGTP or ALP increases obviously.

4.Urobilinogen decreases or is lack of in the stool, such as light grey stool, or white argilla stool.

5.Bilirubin increases in the urine, urobilinogen decreases or is lack of in the urine.

6.The whole cholesterol in the serum increases, and the protein-X is positive.

1.Skin and membranes present light yellow or golden, sometimes skin titillation, but not more serious and common than obstructive jaundice.

2.Direct and indirect bilirubin increases in the blood.

3.Bilirubin in the urine is positive, and urobilinogen increases.

4.Urobilinogen in the stool is normal, lack of or decreases.

5.Serum transaminase increases obviously.

7.     There are more obvious alimentary tract symptoms such as disgusted, vomitive, burbulence and so on.

Ascites is common complicated symptom of liver cancer, especially for later liver cancer. If having hepatocirrhosis, it is more apt to have ascites. Ascites is mainly transudate; if tumor invades liver envelop, or tumor disrupt to the abdomen cavity, or cancer cells transfer to abdominal membrane, there appears bloody ascites; if having ascites infections, there is burbulence, abdominal pains, fever, and even serious poisonous shock. When checked, there is abdominal tenderness and rebound tenderness, white blood cells increasing and shift to the left.

Before ascites appearing, there is intra-intestinal flatulence, and amount of ascites increases intra-abdominal pressure, and forms exomphalos, and raises the diaphragmatic muscle, and causes dyspnea and palpitation. Some patients have dropsy of chest, most at the right side, and dyspnea is obvious.

1.Portal veins pressure increases: tumor grows quickly, and compresses portal veins, hepatic veins or post cava, and tissue fluid decreases and transudes into abdominal cavity and forms ascites.

2.Albumin decreases: because of inanition, liver functions damaged and hepatocirrhosis, the synthesis of albumin decreases, adding to liver cancer consumption, promotes plasma exosmosis and forms ascites.

3.Veins are obstructed: because of hepatocirrhosis, tumor compression, invasion and cancer embolism, blood backflow of hepatic veins is obstructed, which leads hepatic sinus obstruction, and hepatic lymph fluid increases, and if the generating volume of hepatic lymph fluid exceeds the volume that thoracic duct can transport, large lymph fluid will overflow and form ascites.

4.Kidney factors: because of large quantity of ascites, effective circular volume and renal blood volume decreases, and the strain rate of glomeruli of kidney descends, and proximal renal tubules absorb sodium repeatedly, so kidney increases absorbing sodium and water, and decreases egestion.

There are other reasons such as tumor invading hepatic envelop, cancer tubercle creaking into abdominal cavity and cancer transferring to abdominal membrane.

Liver cancer nearby septum can invade chest cavity directly, or transfer to chest cavity through blood and lymph channels, and cause bloody dropsy of chest; ascites enters into chest cavity through interseptum lymphoduct. And dropsy of chest is always at right chest cavity.

Liver cancer patients may have spleen intumesces, great hepatic intumesce, especially left lobe intumesce of the liver. And it is difficult for intumescent spleen to do palpation, and liver is mistaken as intumescent spleen. And tension ascites also can affect the palpation of intumescent spleen.

1.Liver cancer is always with hepatocirrhosis and high portal pressure, so blood backflow of the spleen is obstructed, and spleen is intumescent for splenic congestion.

2.Cancer embolism can cause obstruction of portal and hepatic veins, and blood backflow obstruction, and splenic congestion, and at the situation, spleen intumesce grows quickly.

3.Splenic vein is compressed by tumor, so it affects the blood backflow of the splenic vein.

4.Liver cancer transfers to spleen, but it is rare. Splenic intumesce may be with hypersplenia, and white blood cells, red blood cells and platelet decreases.

Cancerous syndrome is also called ectopic hormone syndrome, and it refers to a group of primary liver cancer patients' symptoms caused by the unusual cancer metabolism or kinds of effect that cancer tissues produce to the mechanism.

Cancerous syndromes of liver cancer have exceeded 50 types, and they are rare but have clinical meaning. And to recognize these syndromes correctly is helpful for early diagnosis while to deal with them is also useful to relief the patients' sufferings. Clinically the syndromes as follows are more serious: hypoglycemia, erythremia, hypercalcemia and hypercholesterolemia. Syndromes as follows are rare: cutaneous porphyria, effemination, carcinoid syndrome, hypertrophic osteoarthropathy, hypertension, hyperparathyroidism and piastrinemia.

1.Erythremia: it is the most common one of cancerous syndromes, and the occurrence rate is 2%~12%, and some hemochrome is as higher as 260g/L. After resection operation, red blood cells and hemochrome can recover to be normal.

2.Hypoglycemia: the occurrence rate is 10%~30%, so pay attention to hypoglycemia and hypoglycemia coma.

3.Hypercalcemia: it is the most serious one, and clinical symptoms are that vague consciousness, weak, hypodynamia, thirsty, hyperuresis, disgusted and vomitive; more serious patients may have hypercalcemia (lethargy, mental disorder and coma)

4.Hypercholesterolemia: its occurrence rate is 38%.

5.Sexual change: there are three types: precocious puberty, gynecomastia and feminizing for man

6.Hyperfibrinogenemia: after resecting tumor, fibrinogen can become normal.

7.Cutaneous porphyria: it is rare, and large quantity of porphyrin is in the liver cancer tissues, and too much porphyrinuria and stool porphyrin is in the urine, and too much porphyrinogen and stool porphyrin is in the stool.

8.Skin: patients have cutaneous leukoplakia, migratory thrombophlebitis and focal round pityriasis.

9.Carcinoid syndromes: they are rare, and symptoms are diarrhea and shock.

10.Others: hyperthrophic osteoarthropathy, hypertension, multiple neural lesion, hyperparathyroidism, piastrinemia, calcitonin ascending, leukemoid reaction, phlogocytosis and hemolytic anemia.

According to report abroad, the occurring rate of hypoglycemia is above 30%, and 8%~27% in our country. And it can be divided into two types: A type, which occupies 87%, and B type, which occupies 13%.

A type: it is at the early stage of liver cancer that tumor grows quickly and has lower differentiation degree, accompanying with obvious consumption and serious muscle emaciation. Usually hypoglycemia is not obvious, and is discovered while checking.

B type: usually there is serious hypoglycemia. Clinical symptom is acute neural syndrome, such as tic, stupor and coma. It is more common at the early stage of hepatocellular carcinoma that tumor grows slowly and differentiates well, but it is difficult to control the hypoglycemia, and it has no reaction to sebaceous hormones, thiazide and diazoxide therapy, and it is possible for patients to die because hypoglycemia cannot be cured.

Hypoglycemia has relation with the following factors:

1.Liver cancer tissues can secret insulin or something like insulin, which creates hypoglycemia.

2.Cancer tissues need consume and intake more glucose to grow, which lowers the blood sugar.

3.Tumor is large, and the glycogen tissues storage in rest hepatic tissues decrease obviously, and hepatic functions are damaged, so other non-carbohydrate cannot be converted into glucose through gluconeogenesis.

4.Tumor intakes glucose, and stores glycogen, but lacks the enzyme that can split glycogen, so glycogen cannot be converted into glucose.

5.B cells in the pancreas gland increases, and insulin increases.

6.Insulin decreases in the liver because of hepatocirrhosis and hepatic function damage, and the use rate of glucose increases, which creates hypoglycemia.

Hypoglycemia caused by liver cancer is complicated, and has many indefinite places. If liver cancer patients have mental or conscious changes of no reasons, and clinically if not because of hepatic coma and other diseases, hypoglycemia should be considered.

In childhood, hepatic tumors can be divided into benign and malignant two types.

1.Malignant tumor: (1) primary liver cancer: hepatobalstoma and hepatocellular carcinoma. (2) hepatic parechymal tumor: such as rhabdosarcoma, leiomyosarcoma, fibrous angiosarcoma, mesenchymal angiosarcoma and malignant interval tumor. (3) bile duct tumor: cholangiocarcinoma and choledochus botryoid angiosarcoma. (4) chorioepithelioma. (5) endodermal sinus tumor. (6) hematopoiesis systems: Hodgkin's disease, non-Hodgkin's lymphoma and leukemia. (7) transferring tumor: neuroblastoma, malposed adrenal tissue tumor, tubercle diseases and Wilm tumor.

2.Benign tumors: (1) hepatocellular carcinoma: hepatic cell gland tumor, congenital hepatic fibrosis and excessive hepatic focal nodular hyperplasia. (2) hepatic cysts: congenital hepatic cyst, acquired parasitic cyst and acquired non-parasitic cyst. Acquired non-parasitic cyst can be divided into dermoid cyst and polycystic liver and kidney. (3) angioma: solitary angioma, hemangioendothelioma, hemangiopericytoma, cavernous tumor and angioleiomyoma. (4) bile duct cystic tumor: intra-hepatic bile duct gland carcinoma, bile duct cystadenoma, papilloma and congenital bile duct cyst. (5) mesenchymal tumor: leiomyoma, fatty tumor, fibrous tumor. (6) mesenchymal-epithelium mixed tumor: hamartoma, benign dysembryoma. (7) others: false inflammatory tumor, malposed pancreas and adrenal rest tumor.

In a word, there are kinds of hepatic tumors of children, and angioma, adenoma and polycystic diseases are more common benign tumors; hepatoblastoma, hepatocelular carcinoma and transferring tumors are more common malignant tumors. Some benign tumors can develop into malignant tumors, such as dysembryoma, leiomyoma, dermal sinus carcinoma and fibrous tumors.

Infantile primary liver cancer can be divided into hepatoblastoma and hepatocellular carcinoma, and it occupies 0.2%~5.8% of the malignant infantile liver cancer. And both the two above liver cancer cells can secrete AFP and somatotrophic sex hormones.

1.hepatoblastoma: it is the most common malignant infantile hepatic cancer, which occupies 86.5% of malignant hepatic cancer. Of all the malignant abdominal tumors, it is the secondly malignant to the Wilm tumor and neuroblastoma.

Hepatoblastoma is very complicated, and heredity and congenital factors are more important than environmental factors.

Clinical symptoms: inappetence, hypodynamia, emaciation, burbulence, abdominal pains, fever, and tumor at right upper abdomen. Tumors grows quickly, and can spread to umbilicus in 1~2 months.

2.hepatocellular carcinoma: it occurs after 3 years old, and for elder ones, it often accompanies with hepatic necrosis, hepatocirrhosis and biliary cirrhosis.

Reasons: it is related with HB, HC, hepatic cirrhosis, AFT, water pollution, chemical matter, radiation, hormones and immune state closely.

Clinical symptoms: after 5~6 years old, there are abdominal tumors, hepatic intumesces, hepatic pains, asitia, vomitive and disgusted. If having cirrhosis, there is ascites or jaundice. It develops quickly in childhood, and is easy to transfer to other organs.

Congenital hepatic fibrosis is also called fibrous vascular gland tumor of bile duct. It is familial and belongs to the autosomal recessive heredity disease and its noxa is not clear. Because of nodular hyperplasia of fibrous tissues at the liver, it is benign hepatic tumor. There is fibrous tissue hyperplasia near by the hepatic portal veins, and the bile duct is ecstatic and deformed, so there is cholestasis. Hepatic artery is normal, but the vein system is sink by compression, especially for portal veins. Hepatic lobe structure and liver cells are normal, there are no degeneration, necrosis and hyperplasia.

Hepatic cyst is benign tumor, and can be divided into congenital and acquired hepatic cyst. Congenital hepatic cyst can be divided into solitary and multiple. Acquired hepatic cyst can be divided into parasitic and non-parasitic. Parasitic cyst is caused by hepatic echinococcus, which is hepatic hydatid cyst. Non-parasitic cyst can be divided into the following eight types: (1)hepatonephric cystic degeneration; (2)lymph duct cyst; (3)cystadenoma; (4)cyst originated from blood vessels; (5)ciliary epithelial cyst; (6)false cyst; (7)dysembryoma; (8)retention cyst.

As the other tumors, liver cancer is not infectious, and one's cancer cells cannot exist in another's body.

The growing and proliferation of liver cancer cells need a certain stable environment, and liver cancer cells cannot exist without this environment. Even if cancer cells enter into another's body, they can be killed and rejected by the immune system of the body.

Liver cancer itself is not infectious even if close touching. We should care for the liver cancer patients.

Liver cancer, HV and cirrhosis are familial, because they live together for a very long time. For occasional general touch such as handshake and visit, we cannot infect chronic HV, or liver cancer.

Hepatic angiomatosis is a kind of common benign hepatic tumor, and can be divided into cavernous tumor, hemangioendothelioma, bayberry angiomatosis, arteriovenous angiomatosis, intermuscular angiomatosis and giant hyperplastic angiomatosis. And cavernous tumor is the most common.

1.cavernous tumor: it is vascular dysmorphosis, and not a true tumor. Because of the unusual blood vessel growth at the growth progress of embryo, intra-hepatic hemorrhage, necrosis, organization, angiectasis and congestion are caused and cavernous tumor is forming.

Clinical symptoms: (1)no symptoms: patients have no obvious symptoms, and most are discovered at somatoscopy, necroscopy and operation, and most tumors are less than 4cm. (2)abdominal tumors: patients have no obvious uncomfortable feelings, and can feel epigastric tumor with the tumor increasing. (3)tumor compressing type: there are correspond symptoms with the increasing tumor compressing the nearby organs. When compressing gastrointestinal tract, there is burbulence; when compressing portal veins and hepatic veins, there is dropsy of lower limb and ascites; when compressing the bile duct and affecting bile egestion, there is jaundice; if the tumor is big, it may compress hepatic tissues, and damage the hepatic function slightly; this type can occupies 50%~60% of cavernous tumor. (4)intra-hemorrhage: tumor may crack and bleed under the external force or sudden increasing intra-abdominal pressure, so patients may appear hemorrhage shock, which has a high death rate.

2.hepatic hemangioendothelioma: this tumor is constituted of capillary endothelial cells, and is solitary mostly. And most occur at the right lobe of liver. Some cases appear spreading inside the liver, which is called diffuse type.

Congenital intra-hepatic bile duct cystic dilation is also called Caroli, and pay attention to differentiate it with liver cancer, because its symptoms are progressive hepatic intumesces and abdominal pains.

It belongs to the autosomal recessive hereditary disease, and some patients may accompany with tubular ectasia. The illness bile duct inside the liver presents segmental cystic dilation, and there is cholestasis with biliary calculus inside the bile duct cavity. Because of unobstructed bile egestion, there is cholangitis and cholecystitis repeatedly, and form hepatomegaly infections, and septicemia for serious ones. Liver function is not damaged, and there is no cirrhosis or high portal pressure.

Hepatic focal nodular hyperplasia is a benign non-progressive lesion, and it is not cancer foci, and also cannot develop into cancer.

It cannot be differentiated with liver cancer under images, so it can be diagnosed depending on B ultrasonic or laparotomy biopsy.

Hepatocellular gland tumor is benign hyperplasia of liver cells, and is related with oral contraceptive of women, but we cannot exclude the possibility of that some cases may develop into malignant ones.

It is benign tumor, and cannot develop into cancer, but some cases may develop into hepatocellular carcinoma. Once it is discovered, resection operation should be adopted. If not proper for operation, patients should be observed closely, and prevented from cancer.

Hepatic lipoma is benign tumor originated from the liver, and is not dangerous.

Characters: liver can be normal or bigger slightly, and fatty tumor is mainly constituted of mature fatty cells and loose connective tissues. Angiolipoleiomyoma has trilogy histologically: blood vessels, smooth muscle and fatty tissues, and the fat content is not certain between 30% and 80%. The characters of myeloid fatty tumor arethat there are obvious pulpy tissues among the fatty cells, which include megacaryocyte and blood cells, especially erythrocytoblast and myelocyte.

Clinical symptoms: hepatic fatty tumor can attack people at any age, especially older people above 40 years old and fat ones. The patients often accompany with DM, hypertension and arteriosclerotic cardiopathy. Tumor locates at the right lobe of the liver mostly.

Liver cancer can be divided into the following types:

1.general massive check: it is not strict to sort people, but to do massive check.

2.dangerous people check: people who are alcoholic above 35 years old, have chronic liver disease for more than five years and have liver cancer familial history and whose HbsAG is positive should be checked.

3.clinical check: dangerous people who are in hospital for other diseases.

4.somatoscopy: check the workers who are working in the government organizations, factories and troops.

5.successive check: the suspected patients of whose AFP is positive and low concentration after the above check should do successive check.

1.AFP test: check the serum AFP level of every object. And its disadvantage is that patients of whose AFP is negative may have been left out.

2.AFP test with B ultrasonic check: it can make up the defect of AFP test.

3.B ultrasonic in the operation: it can make up the defect of B ultrasonic, and the defect of that the small cancer cannot be touched in the operation.

1.AFP test: AFP test has used to check liver cancer for more than 20 years long, and is still used now. It is convenient, cheap, smart, accurate and reliable.

AFP has a certain degree of false positive, which occupies 30% of all the checking results.

In all the AFP increasing cases, we should exclude the AFP increasing cases caused by other diseases, such as chronic liver diseases, gonadal embryonal carcinoma and pregnancy, then consider the possibility of liver cancer. Patients then should do further check, such as somatoscopy, B ultrasonic and other images check, especially for liver and germinal system, and liver function check;

2.B ultrasonic: the positive rate of AFP test to the liver cancer patients is 70% in our country, and it is to say that 1/3 of the liver cancer patients cannot get early diagnosis under AFP test.

B ultrasonic is more and more common, and with the development of the instruments and the increasing diagnosing level of the doctors, B ultrasonic can even discover the intra-hepatic tumor of which diameter is shorter than 1cm. Color Doppler can check the sanguinous power phenomenon of the tumor, which is meaningful to diagnosis. AFP test with B ultrasonic can be the check method to liver cancer in a certain scope.

Although liver cancer is the most malignant tumor in our country, massive check is very difficult, expensive, and ineffective.

How to define dangerous people is different in different places. Patients, of whose HbsAg are positive and who have chronic liver diseases or liver diseases familial history, especially for males, should be sorted as dangerous people. The age standard is different. For example, it is above 30 years old in Qidong and Chongqing, above 40 years old in Shanghai and Singapore, above 20 years old in Alaska of America. Long term alcoholic and HCV are the main reasons of liver cancer and cirrhosis in western countries, so people who are alcoholic and have blood transfusion are sorted as dangerous people.

If there is intra-hepatic occupying lesion through B ultrasonic, it has many disease reasons besides primary liver cancer. Primary liver cancer can be diagnosed definitely mostly according to B ultrasonic and other clinical symptoms and checks. We should differentiate with the following diseases clinically:

1.hepatic angioma: it is benign tumor, grows slowly, and soft. There is thick limbic interface echophony in the tumor. And color Doppler is useful to diagnosis.

2.transferring liver cancer: even if it is small, there is low echophony or no echophony area, mainly at the center of the foci, and patients have tumors at the other positions.

3.hepatocirrhosis: nodular hepatocirrhosis can present diffuse nodular regenerative echophony, and is easy to be confused with diffuse liver cancer.

4.hepatomegaly: its image under B ultrasonic is similar with hepatocellular carcinoma at the early stage.

5.remaining hepatic cavity after operation: the space that is left after tumor resection operation is often filled with gelatin sponge, and there is powerful even echophony.

6.false inflammatory tumor: its ultrasonic image is similar with small liver cancer when the tumor is small.

7.hepatic fatty tumor: it is rare, and there is clear powerful echophony under B ultrasonic.

8.others: such as hepatic glands carcinoma, hepatic hydatid, hepatic tuberculosis and other hepatic tumors should be paid attention to differentiate with liver cancer.

B ultrasonic is a convenient, economic and effective method. It can give qualitative analysis and localization to liver cancer, and test if there is cancerous embolism. It can diagnose the accurate rate of liver cancer, the evaluation of tumors' number and localization.

But there is “dead corner” with B ultrasonic, and “dead corner” refers to the areas that ultrasonic cannot reach, which is the disadvantage of B ultrasonic.

FCL is a special type of hepatocellular carcinoma, and it is a kind of high differentiating tumor originating from hepatic cells. There is large quantity of collagne fibers among the interval of cancer cells presenting laminar arrangement, so it is called FCL.

Pathologic characters: the foci are great solitary tubercles, and are also multiple nodules, and their sizes are different, and the big ones can be more than 20cm. The boundary of the tumor is clear, but has no envelope. There are collagne fibers among the interval of cancer cells presenting laminar arrangement, so they part the tumor tissues into slices or pieces. HBsAg and AFP are positive mostly, and the foci tissues include copper binding protein.

It is not rare, and according to the report of Farhi, Ten cases are FCL in 23 primary liver cancer cases below 35 years old. It attacks the people aged between 5 and 35 years old, and has no relation with HV, alcohol and contraceptive.

It develops slowly, and it takes 11 months from discovering the foci to having symptoms. Jaundice and ascites are rare, and lab check is not meaningful to this disease. ALP, GGT, ALT and serum bilirubin are normal mostly. AFP has slightly increased in only 10% of FCL, so AFP is also not meaningful. It is not easy to differentiate with common liver cancer under B ultrasonic and CT check.

Hepatobiliary cell carcinoma is a kind of malignant tumor originating from Hering bile duct, and it belongs to primary liver cancer. It is more rare than hepatocellular carcinoma, and male patients are more than females, but 1/3 of female primary liver cancer is hepatobiliary cell carcinoma. It attacks people mostly at 50~60 years old.

Its reason is not clear now, and may relate with the following factors generally: (1)hepatobiliary calculus: bile duct calculus and cholangitis cause bile duct atypical epithelial hyperplasia, and develops to cancer. (2)parasite: Clonorchis infections. (3)HBV: it has no close relations with HBV. (3)others: mental factors and the patients' self conditions.

The clinical symptoms of hepatobiliary cell carcinoma can be divided into two types: the first is tardive hepatobiliary cell carcinoma after hepatobiliary calculus operation and patients have the following characters: (1) they have choleric diseases and a long bile duct operation history; (2)cholangitis attacks them again and again, and they have continuous hepatic pains, irregular fever, but no jaundice. But some late cases or cases with rest calculus of the bile duct may have jaundice; (3)ALP, LDH, GGT in the serum increases, and there are bile duct dilation, bile duct calculus, or occupying lesion inside the liver through B ultrasonic or CT check; (4)in the course of operation, hepatic tumor, cancerous embolism in the bile duct, narrow bile duct, spastic bile duct but not smooth, and lymph node intumesce of the hepatic port can be discovered.

The second type has not clear reasons or can be called primary biliary cell carcinoma, and its clinical symptoms are similar with hepatocellular carcinoma.

Hepatobiliary cell carcinoma accompanied with cirrhosis is rare. But in the early period, it has the trend of spreading inside and outside the liver, and its metastasis to far organs and lymph node is more common. The transferring ways are as followings; (1)cancer cells enter into hepatic sinusoid and spread to the near hepatic parenchyma; (2) invade the portal veins and transfer to intra-liver through blood; (3) transfer to hepatic port and lymph nodes nearby the ventral aorta through lymph duct; (4)spread through the neurilemmal membrane; (5)spread to far away along the bile duct wall, and lymph metastasis is the most common.

Secondary liver cancer can also be called transferring liver cancer, and it is formed by the tumor from other organs of the whole body transferring to the liver. And sometimes it cannot be differentiated with primary liver cancer. Especially the early diagnosis of sub-clinical secondary liver cancer is rather difficult.

(1)symptoms: it has no clear symptoms at the early stage, and once patients are uncomfortable, tumor has been very big. With the tumor increasing, patients may have hepatic pains, emaciation, dynamic, epigastric tumor. And at the late stage, patients may have jaundice, ascites and cachexia. Because primary liver cancer accompanies without cirrhosis, it develops slowly with few complicated symptoms.

(2)lab test check: the AFP of 90% of primary is less than 25μg/L. ALT and AST of the liver functions are normal, and if having clinical symptoms, ALP and GGT may increase.

(3)image check: solitary or multiple foci can be discovered inside the liver through B ultrasonic or CT check. Mixed unequal or low density is presented through CT check.

Diagnosing basis includes: (1)having the history of hepatic tumor or proof; (2)AFP or GGT ascends without unusual liver functions; (3)solitary or multiple occupying lesion is discovered through B ultrasonic or other image checks; (4)hepatic biopsy proof; (5) hepatic metastasis is discovered after operation of primary liver cancer.

CT scan can be divided into two types.

(1)common CT scan: it is that scanning the liver without any contrast medium. It is sensitive to intra-hepatic calcification or hemorrhage foci, or presents diffuse hepatic diseases, such as fatty liver, pigmented symptoms and hepatic glycogen storage disease. Common scan is not better than intensive scan at presenting tumor, but it is valuable at diagnosing metastasis liver cancer.

(2)intensive scan: scan the liver after injecting contrast medium by blood vessel (veins or arteries). Its purpose is that increasing the sensitive of presenting and presenting the hepatic blood vessels better.

Common CT scan is cheap, economic and non-traumatic, but is not sensitive, especially for small liver cancer. But intensive scan, especially CT angiography, can improve the detection rate of liver cancer and small liver cancer. It is traumatic and expensive, and cannot be the first check method. Generally we combine common and intensive scan to check.

(1)common CT check presents liver cancer is low density, and 12% is equal density. And equal density foci are not easy to be discovered. Partial necrosis of the tumor or fat infiltration can form obvious low density; but calcification and fresh hemorrhage inside the tumor may form high density.

(2)tumor may be solitary, multiple, or diffuse changes.

(3)the boundary of tumor is not clear, but some tumors with envelopes may have clear boundary with around hepatic tissues.

(4)arterial period show by intensive scan: liver cancer with rich blood vessels may be high density, which maintains a short period, and changes into short mixed density or even density after 20~30 seconds, and then to be low density; liver cancer without rich blood vessels has no high density.

(5)portal vein period show by intensive scan: cancer foci are low density mostly, but a few of them are high density or even density, which is related with liver parenchyma and blood supply characters of the tumor. Intensive scan can improve the detection rate, but sometimes it can change the equal density, so it should be combined with the common scan.

(6)delayed scan: tumor mostly is low density.

(7)tumor envelops: envelope is thin circular, low density or not clear by common scan; it has not strengthened at the early stage of the intensive scan, and it presents circular high density by delayed scan

(8)blood vessels: intra-hepatic portal veins are concerned with liver cancer, and cause cancerous embolism. The thickness of the stem and branch is not proportion by CT check; cancer embolism is low density after strengthening. Hepatic vein and postcava may also be concerned.

(9)lymph node metastasis: hepatic lymph metastasis is the most common, but the detection rate of CT check is very low.

(1)B ultrasonic: when the phonic enters into the body, it can form echo sign by the interfaces, and images are presented at the B ultrasonic.

(2)CT: the absorbing coefficient of the different tissue of the body is different, and it can be dealt with the computer and images are formed.

(3)MRI: the hydric atomic nucleus in the body is stimulated by the radio frequency pulse, and signals are formed to be images.

(4)nuclein images: it is a functional image.

(5)X-ray angiography: it can be considered if having the following symptoms: ① suspected liver cancer patients clinically; ② all kinds of image checks have contradictory results; ③ fatty liver ; ④ tumor, of whose diameter is smaller than 2cm, is discovered inside the liver; ⑤ the accuracy rate of X-ray angiography is better than CT check.

At present, there are many image checks to liver cancer, and any of them has advantages and disadvantages. So doctors should use comprehensive images check according to the clinical condition, and improve the diagnosing correct rate.

For 1.5%~10% of the liver cancer patients, cancer tumor can invade bile duct, and cause obstructive jaundice.

Cancer can break the bile duct, and grow in the duct. Tumor inside the bile duct can have hemorrhge, necrosis and hemagglutination, and patients have jaundice and abdominal pains. Jaundice is slight or medium, and pains are continuous bulge pains with paroxysmal intensity. If obstruction is serious, pressure inside the bile tract will increase suddenly, and spasm of the sphincter muscle of bile duct can be caused, and patients will have the symptoms of biliary colic, disgust, vomitive, jaundice, fever and cold shivers. And it is easy to be diagnosed as biliary calculus. Through treatments, fallen tumor necrosis tissues and hemagglutination can enter into intestine tract, and jaundice and abdominal pains can be relieved. But if having bile duct closure caused by fallen tumor necrosis tissues and hemagglutination again, jaundice and biliary colic are relapsing again.

Liver cancer invading bile tract is a special type at late period, and patients with jaundice have been into the late period.

(1)diagnosis standard of primary liver cancer established by China anti-cancer association and national office of preventing tumors in 1990:

Pathologic diagnsis: ① liver cancer patients diagnosed by hepatic histology check. ② hepatocellular cancer diagnosed by histology check outside the hepatic tissues.

Clinical diagnosis: first, if having no other proof, AFP convection is positive or radioimmunity≧400μg/L lasting for four weeks, but expelling the reasons of pregnancy, kinetic liver disease, gonad embryoma and liver cancer metastasis. Secondly, parenchymal occupying lesion inside the liver can be discovered obviously through image check, but expelling the reasons of hepatic afferent cancer and metastasis liver cancer, and meet one of the following conditions: ① AFP≥200μg/L; ② typical image presenting of primary liver cancer; ③ no jaundice but ALP or GGT ascends; ④ have obvious metastasis foci or blood ascites, or discover cancer cells in the ascites; ⑤ cirrhosis with positive HBsAg.

(2) diagnosis standard of primary liver cancer by liver cancer professional committee of Sichuan province in 1990:

Pathologic diagnosis: primary liver cancer proved by histology check.

Clinical symptoms, meet one of the following conditions: ①through radioimmunoassay, AFP≥400μg/L for more than one month, or 200μg/L ~400μg/L for more than two months, but expelling the reasons of kinetic liver disease, pregnancy, malignant gastrointestinal tumor and gonad embryoma. ②more than two items are positive through B ultrasonic, CT and choleicartery visualization, but expelling the reasons of primary liver cancer and cavernous tumor. ③have liver cancer clinical symptoms, and one of the above images checks is positive, and two items of GGT-Ⅱ isoenzyme, AFP heterogenicity, ferroprotein, fucosidase and abnormal prothrombin are positive.④ have liver cancer clinical symptoms, and have metastasis foci (lung, bone, lymph node at the collar bone), or bloody ascites, but expelling secondary liver cancer.

The occurring rate of biliary and cholecystis carcinoma is similar with hepatocellular cancer, and 0.02%~0.03% of people can be attacked by this carcinoma. And women patients is two times as the men patients. The lesion positions are cholecystis and bile duct branch, and most of them are chronic infections of bile tract and cholecystis.

Clinical symptoms: if it is milky carcinoma, jaundice can be discovered at the early stage. Generally it can be discovered in the late stage, exhausted, anemia, touchable tumor and jaundice in the late stage.

Diagnosis ways: clinical check, lab test; abdominal B ultrasonic and CT check; endoscopy or ERCP; PTC.

Pancreatic carcinoma presents ascending, and 0.05%~0.06% of people can be attacked every year in middle Europe. It occupies 5%~8% of the whole dead rate caused by cancer. And men patients are about three times as women patients.

It is related with drinking coffee for long time, eating fatty food, chronic inflammation (cholecystitis and pancreatitis), smoking and alcohol.

Pancreatic carcinoma can be divided into duodenal papilla carcinoma, papillary carcinoma, carcinoma of caput of pancreas, carcinoma of body of pancreas and carcinoma of tail of pancreas.

Its early symptoms are few and not typical, and have abdominal pains of non-fixed positions; its late symptoms are: jaundice, touchable tumor (Courvoisier's sign), losing weight and abdominal pains.

The treatments methods to liver cancer can be divided into operation, chemotherapy, radiotherapy and comprehensive therapy.

(1)operative abscission: if tumor can be cut off, especially small tumor discovered at the early stage, the living rate in five years is 38%. Operation not only can cut off the tumor, but also it can improve the anti-cancer ability of body. but unsuitable operation may damage the anti-cancer ability of the body. In a certain way, results of palliative abscission or re-operation to the metastasis and relapsing foci is not satisfying, but for early liver cancer, it is meaningful.

(2)non-operative partial therapy: operation is one way to treat liver cancer, but 80% of liver cancer patients in our country are with cirrhosis, 90% of the patients cannot be operated. They should select comprehensive therapy, improve the quality of their life, and prolong the life span. Comprehensive therapy is an important therapy method. At presents, clinical methods also have froze, high temperature, dehydrated alcohol injection, electric chemotherapy and interval radiotherapy.

(3)interventional treatment: it is being the main therapy method to the medium or late patients who cannot accept operation. Some patients may get the chance of doing operation after doing interventional treatment.

(4)immune and guide therapy: at present, immune therapy is an assistant therapy method, and it is expensive, and cannot be made widely available.

(5)the whole body chemotherapy: it has bad effect, and poor reaction, and is used rarely at home and abroad.

(6)radiotherapy: it plays the role of palliative therapy, and prevents the tumor from growing. If proper used, it can relief pains, and prolong life span.

(7)liver transplantation: it is effective method to cure liver cancer, but there is also relapse after transplantation, and because of technology and the liver source, it is used at home and abroad.

(8)comprehensive therapy: the symptoms and body can be improved by comprehensive therapy, especially tumor attack and toxin elimination therapy method, which can reduce the tumor, and improve the quality of life.

Operation, to many early and medium tumor patients, is a effective therapy method, but it also has disadvantages, and it can creates new traumatism, and if do resection, normal tissues may be damaged, and after operation, there are some compliations and dysfunctions. Some operation is dangerous, and if having lymph metastasis or invading important organs or great blood vessels, doctors cannot carry out operation.

Any operation has certain adaption and applying scope that not every patie