合并门静脉癌栓的原发性肝癌非手术治疗的研究进展

Progress in Non-Surgical Treatment of Primary Hepatocellular Carcinoma with Combined Portal Vein Carcinoma Thrombosis

摘要: 门静脉癌栓是肝细胞癌中常见的、具有挑战性的并发症，也是决定肝细胞癌预后的重要因素。在许多患有晚期肝细胞癌的门静脉癌栓病例中，选择治疗方案是非常困难的。与没有门静脉癌栓的肝细胞癌患者相比，有门静脉癌栓的肝细胞癌患者表现出更差的肝功能、更低的治疗耐受性和预后，并且具有更高的相关合并症风险。东西方在肝细胞癌合并门静脉癌栓形成的治疗方面存在巨大差异，且目前还没有全球共识和标准指南。近年来，患有门静脉癌栓的肝细胞癌患者有了更多的治疗选择。如手术、经动脉化疗、放射治疗、放射性栓塞、索拉非尼和联合治疗都有在使用。本文就肝癌合并门静脉癌栓的几种常见非手术治疗方式及其不同联合方案进行简要阐述，以期为临床合并门静脉癌栓的肝细胞癌患者的诊疗提供帮助。

Abstract: Portal vein carcinoma embolism is a common and challenging complication in hepatocellular carci-noma and an important determinant of prognosis in hepatocellular carcinoma. In many cases of portal vein carcinoma embolism with advanced hepatocellular carcinoma, the choice of treatment options is very difficult. Patients with hepatocellular carcinoma with portal vein thrombosis exhibit poorer liver function, lower treatment tolerance and prognosis, and have a higher risk of associated comorbidities than patients with hepatocellular carcinoma without portal vein thrombosis. There are significant differences between the East and West in the treatment of hepatocellular carcinoma combined with portal vein thrombosis, and there is no global consensus or standard guidelines. In recent years, more treatment options have become available for patients with hepatocellular carci-noma with portal vein thrombosis. For example, surgery, transarterial chemotherapy, radiation therapy, radioembolization, sorafenib, and combination therapy are in use. This article briefly de-scribes several common non-surgical treatment modalities for hepatocellular carcinoma combined with portal vein carcinoma thrombosis and their different combination regimens, with the aim of providing assistance in the clinical management of patients with hepatocellular carcinoma com-bined with portal vein carcinoma thrombosis.