消化系统第七讲（Seventh lectures on the digestive system）.docVIP

消化系统第七讲（Seventh lectures on the digestive system） Liver cancer I. etiology and pathology Liver cancer is classified into pathological types: massive, nodular, and diffuse. According to the classification: hepatocellular carcinoma (the most common), cholangiocarcinoma, mixed type By size: small hepatocellular carcinoma 2mm Small hepatocellular carcinoma, 2cm, 5cm Large hepatocellular carcinoma, 5cm, 10cm Giant hepatocellular carcinoma 10cm Remember two small five will do, small two refers to tiny liver cancer 2cm, small five refers to small liver cancer 5cm Metastasis of liver cancer: primary liver cancer is easy to invade the branch of intrahepatic portal vein, and the tissue of the portal vein and branch of intrahepatic portal vein flows into and out of the liver through portal vein blood flow, which not only aggravates portal hypertension. And the formation of multiple liver cancer foci. (so, the most important metastatic place of primary liver cancer is intrahepatic dissemination, which belongs to hematogenous metastasis.) The most metastatic to the liver is the lung, followed by the bone, brain and liver, adjacent organs such as the stomach, pancreas and so on. Two. Clinical manifestation The early stage of primary liver cancer usually lacks typical symptoms, and the treatment is usually late. 1., the liver area pain, which is the first symptom of liver cancer, mostly persistent pain or blunt pain, if there is a sharp pain, that is, the liver surface of the ruptured nodules. 2. hepatomegaly of hepatomegaly, this is a very specific performance, if there are generally of hepatomegaly, we think of liver cancer. Generally speaking, if one has what progressive symptoms and signs, all indicate malignant changes, such as esophageal cancer, progressive dysphagia. Bile duct cancer, progressive jaundice. So, remember this typical thing. The enlarged liver is firm, rugged, and of unequal size, and the edge is blunt and irregular. However, if the cancer is located on the di