Chapter 184 - 168: Diagnosis Confirmed! An Invitation to the Partial Hepatectomy

Chapter 184: Chapter 168: Diagnosis Confirmed! An Invitation to the Partial Hepatectomy

After their previous consultation, Director Fu had come to highly approve of Wu Ting.

Factoring in the attitudes and connections of influential figures like Shen Siyuan, Shao Yuqiao, Shen Xiaofei, and Shen Guofeng, Director Fu now considered Wu Ting one of his own.

So when he received Wu Ting’s call, Director Fu took it very seriously.

"Wu Ting, I understand. Have the patient come over this afternoon. I’ll take her for a detailed and comprehensive examination."

"In a bit, send me all the patient’s current physical examination data in advance. I want to take a look first."

After coordinating with Director Fu, Wu Ting added the patient’s contact information, telling her she could reach out anytime if anything came up.

He then took pictures of the patient’s various physical exam results and indicator values and sent them to Director Fu. Along with them, he included a brief analysis explaining the reasoning behind his conclusion.

This patient was also the first case where Wu Ting had demonstrated the P3 Early Diagnosis Skill for Chronic Hepatitis B-related Primary Hepatocellular Carcinoma, so he was paying close attention.

Sheng Ping was very grateful for Wu Ting’s diagnosis. After thanking him, she left the consultation room.

Dr. Cao had also finished his morning clinic hours and was preparing to get off work.

[Ding! Congratulations to the Host for completing a diagnosis with Attending Physician Cao Dongge, allowing a patient to discover liver cancer in its early stages and receive timely treatment. You have obtained a trait from Cao Dongge: Partial Hepatectomy (Purple). Although he is only an attending physician, as a Lin Chuan "maniac," Cao Dongge’s hepatectomy skills are already on par with provincial-level experts, rivaling that of a typical chief physician.]

Looking at this trait, Wu Ting was a little surprised. ’This Dr. Cao is really more than meets the eye.’

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「Hepatic Tumor Surgery.」

After receiving the patient’s files, Director Fu began to examine them carefully, growing more and more astonished the more he read.

He was unfamiliar with Wu Ting’s completely new diagnostic technique and its focus on indicators related to coagulation dysfunction.

’Could this be a new theory from the latest international journals?’

If it were truly possible to make a highly sensitive assessment of primary hepatocellular carcinoma in a chronic hepatitis B patient just by using these coagulation function indicators combined with routine liver biochemical tests, it would be incredibly exciting news.

As the director of Hepatic Tumor Surgery, Director Fu had diagnosed far too many patients. He had seen too many white-haired parents mourning their children who died young, too many patients who were already in the mid-to-late stages of liver cancer by the time they were diagnosed. All he could do for them was make their final days a little more dignified, their quality of life a little higher.

But if there was a method that could screen for these deeply hidden cases of primary hepatocellular carcinoma in their early stages, it could save countless lives.

Early-stage liver cancer is defined as a single tumor no larger than 5cm in diameter, or as multiple tumors (up to three) that are each no larger than 3cm in diameter. If the patient’s liver function is also largely normal, they can receive curative surgical treatment.

If early-stage liver cancer is diagnosed in time, patients who receive proper treatment—primarily curative resection via surgery—can be considered clinically cured if they show no signs of tumor recurrence during a five-year follow-up period.

Based on Director Fu’s experience, the clinical cure rate for such cases at the Hepatic Tumor Surgery department of Jinggang University Affiliated First Hospital was over 75%!

Of course, there is still a risk of recurrence and metastasis after surgery for early-stage liver cancer. However, recurrent liver cancer can still be treated with a second surgery, radiofrequency ablation, or a liver transplant, offering hope for long-term survival or even a cure.

That was why Director Fu was so amazed by Wu Ting’s new diagnostic technique. Its significance for both patients and doctors was extraordinary.

After a moment of thought, Director Fu turned to the doctors in his department and asked:

"Has anyone heard of using coagulation-related test indicators, combined with routine liver biochemical tests for chronic hepatitis B, to make an early diagnosis of primary hepatocellular carcinoma?"

Director Fu always maintained an open and inclusive attitude toward new technologies and concepts, fostering an excellent academic atmosphere in the department.

He often encouraged his subordinate doctors to read various cutting-edge journals to broaden their horizons. As a result, when faced with new things or new theories within the department, Director Fu wasn’t afraid to ask questions, never letting his pride as the director get in the way.

However, upon hearing Director Fu’s question, all the doctors in the department shook their heads.

"Director Fu, what kind of miraculous diagnostic method is that? I’ve never heard of it. The early diagnosis of primary hepatocellular carcinoma in hepatitis B patients is extremely difficult. Otherwise, there wouldn’t be so many patients missing the optimal treatment window."

"Up until now, haven’t all diagnoses been made using imaging technologies like B-scans, CTs, and MRIs? Because it requires careful observation of the scans, it’s easy to miss in the early stages. By the time a problem is discovered, it’s usually already in the middle or late stage."

After all, the observational ability of the human eye is limited. By the time a problem becomes visually apparent, it’s already quite severe.

That’s why so many hepatic oncologists have been searching for a more efficient, sensitive, and precise diagnostic method. But that was easier said than done.

"Director Fu, why do you ask? Has a professor from a partner institution developed a new theory?"

All the doctors pricked up their ears and looked at Director Fu.

Director Fu shook his head.

"It’s not from another university or institution. Just now, I was informed about a patient from the Hepatobiliary Surgery department who will be coming to our department this afternoon. The outpatient clinic there made a judgment based on several of the patient’s coagulation function indicators and liver biochemical test results. They’re referring her to us for a detailed and comprehensive imaging examination!"

Hearing this, everyone was surprised. Since when did the Hepatobiliary Surgery department have a new technique for diagnosing early-stage primary hepatocellular carcinoma in hepatitis B patients?

Liu Xingye, a senior attending physician under Director Fu, printed out the photos of the various diagnostic reports that the director had sent over.

"What are these reports for?"

Liu Xingye wasn’t very familiar with hand surgery.

Director Fu explained,

"The patient came to our hospital for a hand injury. She has a ruptured tendon in her left hand and will be scheduled for surgery soon, which is why these tests were done. The liver tests were routine, and the four coagulation function tests were also part of the standard preoperative workup."

"I just never expected that these four tests, combined with the routine liver biochemical tests, would become the basis for deducing that the patient has early-stage primary hepatocellular carcinoma."

After hearing Director Fu’s explanation, the other doctors were in disbelief. ’Just who on earth was the doctor who made this diagnosis?’

Several of them pressed Director Fu for the theoretical basis behind this senior expert’s diagnosis.

Having read Wu Ting’s brief explanation, Director Fu relayed it to the group.

"It’s primarily based on three coagulation function indicators: peripheral blood platelet count (PLT), prothrombin time (PT), and prothrombin activity (PTA)..."

Listening to Director Fu’s explanation, everyone was utterly astounded.

"You can do that?!"

"The conventional markers are aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alpha-fetoprotein (AFP) levels. While they have some basis, they generally can’t predict whether chronic hepatitis B will develop into primary hepatocellular carcinoma."

"I never thought you could approach it from the angle of peripheral blood coagulation function!"

Liu Xingye had treated many patients with primary hepatocellular carcinoma at various stages and had accumulated a wealth of experience. Now, hearing this mysterious expert’s novel approach, he began to reason backward from it.

"Patients in the early stages of primary hepatocellular carcinoma do indeed have abnormal coagulation function. The synthesis of coagulation factors is reduced to some extent, leading to a prolonged prothrombin time (PT). It really is a very intuitive and highly sensitive indicator! It’s just that no one has ever tested it qualitatively and quantitatively."

"Furthermore, in early-stage patients, immune function deteriorates and bone marrow is suppressed, leading to a decrease in platelet count (PLT). There really is a strong correlation... Amazing!"

"And because of the cancer’s effect on hepatocytes, the prothrombin activity (PTA) in early-stage patients also declines significantly..."

After this line of reasoning, Liu Xingye was incredibly excited.

"Although I don’t know the specific correlations between these indicators, there’s no doubt that these three are indeed closely related to the progression of primary hepatocellular carcinoma."

’Incredible.’

Though they had never met him, the doctors of the Hepatic Tumor Surgery department were already filled with admiration for the expert who had pioneered this diagnostic technique and yearned to meet him.

"This afternoon, when the patient arrives, let’s give her a thorough and comprehensive examination!"

"No problem!"

The doctors in Hepatic Tumor Surgery were eagerly anticipating the arrival of this patient, referred to them via such a novel diagnostic method.

That afternoon, Sheng Ping went to the Hepatic Tumor Surgery department. The department’s team was already waiting for her, and their enthusiastic reception was so overwhelming that it terrified her.

After all, being given so much attention by so many doctors made her a little flustered.

It was a blessing in disguise. After a meticulous examination by Director Fu’s team, they did indeed find a hidden lesion in the patient’s liver.

It took Director Fu’s vast experience, a comparative analysis of several types of imaging data, and a standard serum alpha-fetoprotein (AFP) test to finally confirm the diagnosis.

The entire medical team was thrilled.

"This is absolutely brilliant! With a conventional workup, even the most senior director would have had a hard time diagnosing this. To think a simple set of coagulation function tests could point to the correct diagnosis."

Director Fu then made an announcement to the department:

"Next, I will invite the doctor who made this diagnosis to participate in Sheng Ping’s surgery and to share and discuss this new technique with all of you."

Because Sheng Ping’s condition was diagnosed so early, she would only need a simple partial hepatectomy.

And based on the diameter of her lesion, a curative resection was highly likely!

An excited Director Fu sent a message to Wu Ting:

"Wu Ting, I’m impressed. Truly impressed!"

"After a careful examination and detailed comparison, our team found the early-stage tumor in the patient’s liver, just as you suspected. The lesion is in a very hidden and deep location. Without your tip, it would have been virtually impossible to diagnose."

"Wu Ting, we’re going to perform a partial hepatectomy on this patient. Would you have time to join us? Our team would love to have you come and exchange ideas."

Wu Ting was delighted when he saw Director Fu’s message. This was an opportunity he couldn’t have hoped for.

"No problem. It would be my honor."

"I’ve also been studying partial hepatectomy recently. If I had the chance to assist in the surgery and learn from you, Director Fu, that would be even better."

Director Fu quickly replied:

"You’re welcome anytime, Dr. Wu. Just come by whenever you have time. Think of our department as your own."

"I’m starting to get a little jealous of Director Shen Siyuan."