[Fat Bear Science] From hepatitis to liver cancer, the only difference is cirrhosis?! Experts remind you to make arrangements to prevent hepatitis...

July 28 this year is the ninth World Hepatitis Day

The theme is "Investing in Hepatitis Elimination"

Hepatitis is one of the diseases that seriously endangers human health. In my country, the most common cause is viral infection. The hepatitis virus replicates and multiplies in the human liver, causing inflammation and necrosis of liver cells, causing continuous damage to the liver.

Hepatitis-cirrhosis-liver cancer is known as the "liver cancer trilogy". The World Health Organization said that in the 15 years from 2015 to 2030, 10 million people in China will die from liver cancer developed from hepatitis.

Chen Weiqing

Director, chief physician, professor, and doctor of the Department of Gastroenterology at the Affiliated Cancer Hospital of Chongqing University. He has conducted in-depth research on the clinical diagnosis and treatment of gastrointestinal bleeding, severe pancreatitis, cirrhosis and its complications, inflammatory bowel disease, etc. He is particularly good at gastrointestinal, hepatopancreatic and other diseases and endoscopic diagnosis and interventional treatment. Clinic hours: Monday morning

Correctly understand viral hepatitis

Viral hepatitis is a common infectious disease worldwide. Currently, about 350 million people in the world live under the shadow of the hepatitis B virus. China is a "severely affected area" with about 80 million hepatitis B carriers, equivalent to 1/10 of the population infected with hepatitis B.

At present, it has been identified that there are at least five types of viral hepatitis, namely hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E.

Hepatitis A is transmitted through ingestion of contaminated food or water or through direct contact with an infected person, while hepatitis E virus is excreted through the feces of an infected person and enters the human body through the intestines. Neither causes chronic liver disease or cirrhosis, and the disease provides lifelong immunity after infection.

Hepatitis B, C, and D are all transmitted through blood, and a few are transmitted through close contact with the patient's saliva, semen, breast milk, etc., such as between husband and wife, and between mother and child. Hepatitis B and C can turn into chronic liver disease, which may develop into cirrhosis or even liver cancer.

Hepatitis A, B, D and E can all be prevented through vaccination.

Recurrent hepatitis may progress to liver cancer

Primary liver cancer is the fourth most common malignant tumor and the third leading cause of cancer-related death in my country, posing a serious threat to the lives and health of the Chinese people.

In my country, the main cause of primary liver cancer is chronic viral hepatitis. About one-third of patients with primary liver cancer have a history of chronic hepatitis.

The viral hepatitis that causes liver cancer is hepatitis B (HBV) and hepatitis C (HCV). About 90% of liver cancer patients in my country have a background of hepatitis B virus infection (not 90% of hepatitis B patients will get liver cancer), and about 5%-8% are anti-HCV antibody positive.

The occurrence of liver cancer is a multi-step, multi-factorial process. 10%-30% of chronic hepatitis B patients develop liver cirrhosis after at least 5-10 years, and 5%-10% of cirrhosis patients develop liver cancer after at least 5-10 years. In some patients, liver cirrhosis and liver cancer develop simultaneously.

Experts remind: Frequent recurrence of hepatitis can easily progress to cirrhosis, liver cancer, etc. If the liver function level is abnormal during the physical examination, you should seek medical attention in time; if you have symptoms such as fatigue, poor appetite, aversion to oil, nausea and vomiting, abdominal distension and pain, fever and chills, you should seek medical attention as soon as possible.

Early symptoms are easy to ignore, and more than 80% of cases are already in the middle or late stages when they are discovered

Liver cancer is very hidden and lacks typical clinical manifestations in the early stage. Many liver cancer patients usually do not feel anything in the early stage. A few patients will have non-specific symptoms such as loss of appetite, upper abdominal distension, fatigue or mild liver enlargement. These symptoms are often easily ignored.

In the middle and late stages of liver cancer, obvious symptoms will appear, such as:

Pain in the liver area Pain in the liver area is one of the common symptoms of late-stage liver cancer, which is mostly persistent distending pain or dull pain.

In more than 90% of patients with hepatoma, the liver shows progressive enlargement, often with varying degrees of tenderness.

Jaundice usually occurs in the late stages of liver cancer.

Patients with liver cancer and signs of cirrhosis accompanied by portal hypertension may have splenomegaly, ascites, and the formation of venous collateral circulation.

Systemic manifestations include progressive weight loss, fever, loss of appetite, fatigue, malnutrition and cachexia.

Symptoms of metastatic lesions If metastasis occurs to the lungs, bones, chest cavity, etc., corresponding symptoms may occur.

Therefore, more than 80% of liver cancer patients are diagnosed in the middle or late stages and have missed the best treatment period.

High-risk groups for liver cancer

■ Hepatitis B and Hepatitis C patients or carriers

■ Those with a family history of liver cancer, especially those with a history of liver cancer in close relatives

■ Alcoholic or non-alcoholic liver disease

■ Those with chronic hepatitis, especially cirrhosis

■ Long-term consumption of pickled, smoked, moldy and other foods

■ Men over 40 years old

■ Long-term residence in areas with a high incidence of liver cancer

Regular physical examinations to detect signs of cancer in time

For high-risk groups, a physical examination should be conducted at least once every six months, including examinations of liver function, HBV DNA, alpha-fetoprotein and liver ultrasound. If active hepatitis, cirrhosis or liver cancer is found, active treatment should be initiated.

The combination of serum alpha-fetoprotein (AFP) testing and liver ultrasound examination is currently an economical, practical and effective method for early liver cancer screening.

Fighting liver cancer starts with preventing hepatitis

There has been a hepatitis B vaccine since 1982. The hepatitis B vaccine is 95% effective in preventing infection and the development of chronic disease and liver cancer caused by hepatitis B.

At present, hepatitis B vaccine has been widely used. Through the hepatitis B vaccine program immunization for newborns and key groups, the number of people infected with hepatitis B virus in my country has been reduced by 30 million. The protection rate of hepatitis B vaccine vaccination is 90-95%, but it may be ineffective for a small number of people.

After vaccination with the hepatitis B vaccine, corresponding antibodies are produced, but as time goes by, the titer of hepatitis B surface antibodies decreases, and it is still possible to be infected when exposed to the hepatitis B virus.

Therefore, people who have been vaccinated with the hepatitis B vaccine should still undergo regular physical examinations and screen for hepatitis B.

Experts give advice to protect your little sweetheart

No.1 Keep a close eye on your diet

Eat less pickled food such as pickles, and avoid eating moldy food. Known food-related carcinogenic toxins include: aflatoxin in moldy grains, nitrosamines in pickled food and leftovers, benzopyrene in smoked food, and polycyclic aromatic hydrocarbons in fried food.

No.2 Reduce alcohol intake

Alcohol is the biggest risk factor for hepatitis B patients to develop cirrhosis and liver cancer. The latest data from the American Society of Clinical Oncology in 2017 showed that 22% of liver cancer is related to drinking.

Alcohol is a catalyst for liver cancer in patients with chronic hepatitis B and chronic hepatitis C. Patients with chronic hepatitis B and chronic hepatitis C must absolutely abstain from alcohol.

No.3 Strengthen physical exercise

Avoid the occurrence of liver cancer risk factors such as fatty liver and diabetes.

No.4 Regular work and rest schedule

Avoid excessive fatigue, staying up late and other bad work and rest habits. Long-term fatigue, especially staying up late, is not conducive to the liver's rest and self-repair.

No.5 Increase your intake of fruits and vegetables

The free radical scavengers contained in it can effectively prevent liver cancer.

No.6 Keep a happy mood

Anger hurts the liver, and negative emotions can also cause great damage to the liver.

Text/Fat Bear Photos/Internet (Please contact us for deletion) Review/Chen Weiqing

Member of China Medical We-Media Alliance

Science Popularization China Co-construction Base

Chongqing Science Popularization Base/Chongqing Health Promotion Hospital

Chongqing Municipal Science and Technology Commission Science and Technology Communication and Popularization Project

National Health Commission National Basic Public Health Service Health Literacy Project