Liver Cancer: Diagnosis
If your healthcare provider thinks you might have liver cancer, you will need certain exams and tests to be sure. Diagnosing liver cancer starts with your healthcare provider asking you questions. He or she will ask you about your health history, your symptoms, risk factors, and family history of disease. Your healthcare provider will also give you a physical exam.
What tests might I need?
You may have one or more of the following tests:
You may have blood tests to look for signs of liver cancer.
Alpha-fetoprotein (AFP) blood test
AFP is a protein in the blood that should go down right after birth. AFP levels are often high in people with liver cancer. But other conditions can also raise AFP levels. So this test alone can't be used to diagnose liver cancer.
Liver function tests (LFTs)
These tests check liver function. They can show liver irritation and inflammation. These tests can't tell for sure if you have liver cancer. But if the tests show that your liver has been damaged, your healthcare provider may do other tests to see if you have cancer.
Imaging tests may also be done to look for liver cancer.
This is often the first test done if your healthcare provider suspects liver cancer. An ultrasound is easy to do and doesn’t use radiation. This test is very helpful in seeing whether a liver tumor is a fluid-filled sac that’s likely not cancer (cyst) or a solid mass that’s more likely to be cancer. An ultrasound uses sound waves to look for abnormalities in the liver. The sound waves bounce off body parts and send back a series of signals. Then a computer turns these signals into images of your body.
Magnetic resonance imaging (MRI)
This test creates detailed images of the liver and nearby organs. An MRI uses magnets and radio waves to take pictures of the inside of the body. MRIs can show more detail than other imaging tests.
Computed tomography (CT scan)
A CT scan uses X-rays taken from many angles. This creates very detailed cross-section pictures of the liver and nearby organs.
If an imaging test shows something in your liver that looks like it might be cancer, your healthcare provider may take small samples of liver tissue. This is called a biopsy. A doctor who specializes in looking at cells, called a pathologist, looks at the samples under a microscope to tell whether cancer is there. There are a few ways to do a biopsy.
For this test, a thin, hollow needle is put through your skin. It goes into the liver tumor to get a sample of it. This is normally done during a CT or ultrasound of the liver. This lets your healthcare provider see the needle going into the tumor.
During laparoscopy, small cuts are made in your abdomen. Then your healthcare provider puts long surgical tools (including one with a tiny video camera on the end) into them. Then he or she looks at the surface of your liver and nearby organs. If your healthcare provider sees small pieces of tumors, he or she will remove them.
Your healthcare provider may take a biopsy during surgery to treat the tumor.
Getting your test results
When your healthcare provider has the results of your biopsy, he or she will contact you with the results. Your provider will talk with you about other tests you may need if liver cancer is found. Make sure you understand the results and what follow-up you need.
March 21, 2017
Clinical Features and Diagnosis of Primary Hepatocellular Carcinoma. UpToDate.
Alteri, Rick, MD,LoCicero, Richard, MD