肝细胞癌合并门静脉癌栓治疗进展
Progress in Treatment of Hepatocellular Carcinoma Combined with Portal Vein Cancer Thrombus
DOI: 10.12677/acm.2026.1672535, PDF,   
作者: 王 锐*, 周 胜, 李水龙, 郭起军：赣南医科大学第一临床医学院，江西 赣州；陈 斌#：赣南医科大学第一附属医院普外科，江西 赣州
关键词: 肝细胞癌；门静脉癌栓；综合治疗；转化治疗；局部治疗；Hepatocellular Carcinoma； Portal Vein Cancer Thrombus； Comprehensive Treatment； Conversion Therapy； Local Treatment
摘要: 肝细胞癌(HCC)恶性程度高，进展快，是全球第四大癌症相关死亡原因。肝脏血供丰富，肝细胞癌在发生发展过程中极易侵犯血管，根据既往文献报道，侵犯门静脉系统并形成门静脉癌栓(PVTT)发生率在10%~60%。PVTT是肝癌预后的负面预测因素，一旦出现PVTT，常预示着肿瘤发生肝内播散和肝外转移，极易导致门静脉高压相关并发症。仅接受支持治疗时，患者的总生存期(OS)仅为2至4个月。伴有PVTT的HCC治疗方式选择有限，国内外指南推荐仍存在争议。近年来，随着TACE、放疗、系统治疗等综合治疗手段的新兴和发展，不同治疗方式均显示出了一定的疗效。本文拟对肝细胞癌合并门静脉癌栓治疗进展作一综述。
Abstract: Hepatocellular carcinoma (HCC) is highly malignant and progresses rapidly, making it the fourth leading cause of cancer-related death worldwide. The liver has a rich blood supply, and HCC readily invades blood vessels during its development and progression. Previous studies have reported that invasion of the portal venous system with the formation of portal vein tumor thrombus (PVTT) occurs in 10%~60% of cases. PVTT is a negative prognostic factor for HCC. Once PVTT develops, it often indicates intrahepatic dissemination and extrahepatic metastasis of the tumor, and it can readily lead to complications related to portal hypertension. With supportive care alone, the overall survival (OS) of patients is only 2 to 4 months. Treatment options for HCC with PVTT are limited, and recommendations in domestic and international guidelines remain controversial. In recent years, with the emergence and development of multimodal treatment strategies such as transarterial chemoembolization (TACE), radiotherapy, and systemic therapy, various treatment modalities have demonstrated certain therapeutic efficacy. This article aims to review advances in the treatment of hepatocellular carcinoma complicated by portal vein tumor thrombus.
文章引用：王锐, 周胜, 李水龙, 郭起军, 陈斌. 肝细胞癌合并门静脉癌栓治疗进展[J]. 临床医学进展, 2026, 16(7): 368-374. https://doi.org/10.12677/acm.2026.1672535

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