肝细胞癌微血管侵犯的治疗进展
Advances in the Treatment of Microvascular Invasion in Hepatocellular Carcinoma
DOI: 10.12677/JCPM.2024.31008, PDF,   
作者: 王 粟:青海大学研究生院,青海 西宁;樊海宁*:青海大学附属医院肝胆胰外科,青海 西宁
关键词: 肝细胞癌微血管侵犯治疗Hepatocellular Carcinoma Microvascular Invasion Treatment
摘要: 虽然肝细胞癌(hepatocellular carcinoma, HCC)采用以根治性切除手术切除为核心的多方式、多学科治疗方式,但术后5年复发率仍达到70%,肝移植术后复发率约为35%。术后肿瘤复发是影响肿瘤患者预后的重要因素,多项研究表明微血管侵犯(microvascular invasion, MVI)是HCC术后早期复发及预后不良的独立危险因素。但是MVI需要术后病理确诊的方式严重限制了其临床价值。本文将从肝细胞癌MVI治疗方案进行文献综述。
Abstract: Although hepatocellular carcinoma (HCC) is treated with a multimodal and multidisciplinary ap-proach centred on radical resection with surgical excision, the 5-year postoperative recurrence rate still reaches 70%, and the recurrence rate after liver transplantation is about 35%. Postoperative tumour recurrence is an important factor affecting the prognosis of tumour patients, and several studies have shown that microvascular invasion (MVI) is an independent risk factor for early post-operative recurrence and poor prognosis of HCC. However, MVI requires postoperative pathological confirmation of diagnosis, which severely limits its clinical value. In this article, we will review the literature from the therapeutic options of MVI in hepatocellular carcinoma.
文章引用:王粟, 樊海宁. 肝细胞癌微血管侵犯的治疗进展[J]. 临床个性化医学, 2024, 3(1): 47-53. https://doi.org/10.12677/JCPM.2024.31008

参考文献

[1] Wei, X., Li, N., Li, S., et al. (2017) Hepatitis B Virus Infection and Active Replication Promote the Formation of Vascu-lar Invasion in Hepatocellular Carcinoma. BMC Cancer, 17, Article No. 304. [Google Scholar] [CrossRef] [PubMed]
[2] Qu, C., Huang, X., Liu, K., et al. (2019) Effect of Hepatitis B Vi-rus DNA Replication Level and Anti-HBV Therapy on Microvascular Invasion of Hepatocellular Carcinoma. Infectious Agents and Cancer, 14, Article No. 2. [Google Scholar] [CrossRef] [PubMed]
[3] Yang, F., Ma, L., Yang, Y., et al. (2019) Contribution of Hepatitis B Virus Infection to the Aggressiveness of Primary Liver Cancer: A Clinical Epidemiological Study in Eastern China. Frontiers in Oncology, 9, Article No. 370. [Google Scholar] [CrossRef] [PubMed]
[4] Lei, Z., Li, J., Wu, D., et al. (2016) Nomogram for Preoperative Es-timation of Microvascular Invasion Risk in Hepatitis B Virus-Related Hepatocellular Carcinoma within the Milan Criteria. JAMA Surgery, 151, Article No. 356. [Google Scholar] [CrossRef] [PubMed]
[5] Li, Z., Lei, Z., Xia, Y., et al. (2018) Association of Preoperative Antiviral Treatment with Incidences of Microvascular Invasion and Early Tumor Recurrence in Hepatitis B Virus-Related Hepatocellular Carcinoma. JAMA Surgery, 153, e182721. [Google Scholar] [CrossRef] [PubMed]
[6] Wang, Z., Duan, Y., Zhang, J., et al. (2020) Preoperative Antivi-ral Therapy and Microvascular Invasion in Hepatitis B Virus-Related Hepatocellular Carcinoma: A Meta-Analysis. Eu-ropean Journal of Pharmacology, 883, Article ID: 173382. [Google Scholar] [CrossRef] [PubMed]
[7] Sanaka, S., Kasarala, G.R. and Tillmann, H.L. (2018) A Down-side to Hepatitis C Virus Cure? Vigilance Is Needed Regarding Hepatitis B Virus Reactivation, Organ Rejection, or Hepatocellular Carcinoma Progression. The Journal of Infectious Diseases, 217, 857-860. [Google Scholar] [CrossRef] [PubMed]
[8] Dave, S., Park, S., Murad, M.H., et al. (2021) Comparative Effectiveness of Entecavir versus Tenofovir for Preventing Hepatocellular Carcinoma in Patients with Chronic Hepatitis B: A System-atic Review and Meta-Analysis. Hepatology, 73, 68-78. [Google Scholar] [CrossRef] [PubMed]
[9] Galle, P.R., Forner, A., Llovet, J.M., et al. (2018) EASL Clinical Practice Guidelines: Management of Hepatocellular Carcinoma. Journal of Hepatology, 69, 182-236. [Google Scholar] [CrossRef] [PubMed]
[10] Heimbach, J.K., Kulik, L.M., Finn, R.S., et al. (2018) AASLD Guidelines for the Treatment of Hepatocellular Carcinoma. Hepatology, 67, 358-380. [Google Scholar] [CrossRef] [PubMed]
[11] Benson, A.B., D’Angelica, M.I., Abrams, T.A., et al. (2014) Hepatobiliary Cancers, Version 2.2021. Journal of the National Comprehensive Cancer Network, 12, 1152. [Google Scholar] [CrossRef] [PubMed]
[12] 国家卫生健康委办公厅. 原发性肝癌诊疗指南(2022年版) [J]. 临床肝胆病杂志, 2022, 38(2): 288-303.
[13] Li, C., Wang, M.D., Lu, L., et al. (2019) Preoperative Transcatheter Arte-rial Chemoembolization for Surgical Resection of Huge Hepatocellular Carcinoma (≥10 cm): A Multicenter Propensity Matching Analysis. Hepatology International, 13, 736-747. [Google Scholar] [CrossRef] [PubMed]
[14] Zhou, Q., Tuo, F., Li, R., et al. (2020) Transarterial Chemoem-bolization Combined with Hepatectomy for the Treatment of Intermediate-Stage Hepatocellular Carcinoma. Frontiers in Oncology, 10, Article ID: 578763. [Google Scholar] [CrossRef] [PubMed]
[15] Guo, C., Zou, X., Hong, Z., et al. (2021) Preoperative Transarterial Chemoembolization for Barcelona Clinic Liver Cancer Stage A/B Hepatocellular Carcinoma Beyond the Milan Criteria: A Propensity Score Matching Analysis. HPB, 23, 1427-1438. [Google Scholar] [CrossRef] [PubMed]
[16] Zhou, Y., Zhang, X., Wu, L., et al. (2013) Meta-Analysis: Preoperative Transcatheter Arterial Chemoembolization Does Not Improve Prognosis of Patients with Resectable Hepatocellular Carcinoma. BMC Gastroenterology, 13, Article No. 51. [Google Scholar] [CrossRef
[17] Yang, Y., Lin, K., Liu, L., et al. (2021) Impact of Preoperative TACE on Incidences of Microvascular Invasion and Long-Term Post-Hepatectomy Survival in Hepatocellular Carcinoma Patients: A Propensity Score Matching Analysis. Cancer Medicine, 10, 2100-2111. [Google Scholar] [CrossRef] [PubMed]
[18] Shin, S.W., Ahn, K.S., Kim, S.W., et al. (2021) Liver Resection versus Local Ablation Therapies for Hepatocellular Carcinoma within the Milan Criteria: A Systematic Review and Me-ta-Analysis. Annals of Surgery, 273, 656-666. [Google Scholar] [CrossRef
[19] Imai, K., Yamashita, Y.I., Yusa, T., et al. (2018) Microvas-cular Invasion in Small-Sized Hepatocellular Carcinoma: Significance for Outcomes Following Hepatectomy and Radiof-requency Ablation. Anticancer Research, 38, 1053-1060.
[20] Lee, S., Kang, T.W., Song, K.D., et al. (2021) Effect of Microvascular Invasion Risk on Early Recurrence of Hepatocellular Carcinoma after Surgery and Radiofrequency Abla-tion. Annals of Surgery, 273, 564-571. [Google Scholar] [CrossRef
[21] Jung, D.H., Hwang, S., Lee, Y.J., et al. (2019) Small Hepatocellular Carcinoma with Low Tumor Marker Expression Benefits More from Anatomical Resection than Tumors with Aggressive Biology. Annals of Surgery, 269, 511-519. [Google Scholar] [CrossRef
[22] Hwang, S., Lee, Y.J., Kim, K.H., et al. (2015) The Impact of Tumor Size on Long-Term Survival Outcomes after Resection of Solitary Hepatocellular Carcinoma: Single-Institution Experience with 2558 Patients. Journal of Gastrointestinal Surgery, 19, 1281-1290.
[23] Ke, Q., Guo, Z., He, J., et al. (2023) Resection Margin Width Does Not Influence the Prognosis of Solitary Hepatocellular Carcinoma after Anatomic Resection: A Real-World Study from China. Journal of Hepatocellular Carcinoma, 10, 1353-1365. [Google Scholar] [CrossRef
[24] Poon, R.T.P., Fan, S.T., Ng, I.O.L., et al. (2000) Significance of Resec-tion Margin in Hepatectomy for Hepatocellular Carcinoma: A Critical Reappraisal. Annals of Surgery, 231, 544-551. [Google Scholar] [CrossRef] [PubMed]
[25] Shi, M., Guo, R.P., Lin, X.J., et al. (2007) Partial Hepa-tectomy with Wide versus Narrow Resection Margin for Solitary Hepatocellular Carcinoma: A Prospective Randomized Trial. Annals of Surgery, 245, 36-43. [Google Scholar] [CrossRef] [PubMed]
[26] Zhong, F.P., Zhang, Y.J., Liu, Y. and Zou, S.B. (2017) Prognostic Impact of Surgical Margin in Patients with Hepatocellular Carcinoma: A Meta-Analysis. Medicine (Baltimore), 96, e8043. [Google Scholar] [CrossRef
[27] Tsilimigras, D.I., Sahara, K., Moris, D., et al. (2020) Effect of Surgical Margin Width on Patterns of Recurrence among Patients Undergoing R0 Hepatectomy for T1 Hepatocellular Carcinoma: An International Multi-Institutional Analysis. Journal of Gastrointestinal Surgery, 24, 1552-1560. [Google Scholar] [CrossRef] [PubMed]
[28] Wang, H., Yu, H., Qian, Y.W., Cao, Z.Y., Wu, M.C. and Cong, W.M. (2020) Impact of Surgical Margin on the Prognosis of Early Hepatocellular Carcinoma (≤ 5 cm): A Propensity Score Matching Analysis. Frontiers in Medicine (Lausanne), 7, Article No. 139. [Google Scholar] [CrossRef] [PubMed]
[29] Yang, P., Si, A., Yang, J., et al. (2019) A Wide-Margin Liver Re-section Improves Long-Term Outcomes for Patients with HBV-Related Hepatocellular Carcinoma with Microvascular Invasion. Surgery, 165, 721-730. [Google Scholar] [CrossRef] [PubMed]
[30] Han, J., Li, Z.L., Xing, H., et al. (2019) The Impact of Resection Margin and Microvascular Invasion on Long-Term Prognosis after Curative Resection of Hepatocellular Carcinoma: A Multi-Institutional Study. HPB (Oxford), 21, 962-971. [Google Scholar] [CrossRef] [PubMed]
[31] Sun, J.J., Wang, K., Zhang, C.Z., et al. (2016) Postoperative Adju-vant Transcatheter Arterial Chemoembolization after R0 Hepatectomy Improves Outcomes of Patients Who Have Hepa-tocellular Carcinoma with Microvascular Invasion. Annals of Surgical Oncology, 23, 1344-1351. [Google Scholar] [CrossRef] [PubMed]
[32] Ye, J.Z., Chen, J.Z., Li, Z.H., et al. (2017) Efficacy of Postopera-tive Adjuvant Transcatheter Arterial Chemoembolization in Hepatocellular Carcinoma Patients with Microvascular Inva-sion. World Journal of Gastroenterology, 23, 7415-7424. [Google Scholar] [CrossRef] [PubMed]
[33] Chen, Z.H., Zhang, X.P., Zhou, T.F., et al. (2019) Adjuvant Transarterial Chemoembolization Improves Survival Outcomes in Hepatocellular Carcinoma with Microvascular Invasion: A Systematic Review and Meta-Analysis. European Journal of Surgical Oncology, 45, 2188-2196. [Google Scholar] [CrossRef] [PubMed]
[34] Wang, L., Chen, B., Li, Z., et al. (2019) Optimal Postoperative Ad-juvant Treatment Strategy for HBV-Related Hepatocellular Carcinoma with Microvascular Invasion: A Propensity Score Analysis. OncoTargets and Therapy, 12, 1237-1247. [Google Scholar] [CrossRef
[35] Wang, L., Wang, W., Rong, W., et al. (2020) Postoperative Adjuvant Treatment Strategy for Hepatocellular Carcinoma with Microvascular Invasion: A Non-Randomized Interventional Clini-cal Study. BMC Cancer, 20, Article No. 614. [Google Scholar] [CrossRef] [PubMed]
[36] Yang, J., Liang, H., Hu, K., et al. (2021) The Effects of Several Postoperative Adjuvant Therapies for Hepatocellular Carcinoma Patients with Microvascular Invasion after Curative Re-section: A Systematic Review and Meta-Analysis. Cancer Cell International, 21, Article No. 92. [Google Scholar] [CrossRef] [PubMed]
[37] Bruix, J., Takayama, T., Mazzaferro, V., et al. (2015) Adjuvant Sorafenib for Hepatocellular Carcinoma after Resection or Ablation (STORM): A Phase 3, Randomised, Double-Blind, Placebo-Controlled Trial. The Lancet Oncology, 16, 1344-1354. [Google Scholar] [CrossRef
[38] Huang, Y., Zhang, Z., Zhou, Y., Yang, J., Hu, K. and Wang, Z. (2019) Should We Apply Sorafenib in Hepatocellular Carcinoma Patients with Microvascular Invasion after Curative Hepatectomy? OncoTargets and Therapy, 12, 541-548. [Google Scholar] [CrossRef
[39] Zhang, X.P., Chai, Z.T., Gao, Y.Z., et al. (2019) Postoperative Adju-vant Sorafenib Improves Survival Outcomes in Hepatocellular Carcinoma Patients with Microvascular Invasion after R0 Liver Resection: A Propensity Score Matching Analysis. HPB, 21, 1687-1696. [Google Scholar] [CrossRef] [PubMed]
[40] Gu, W. and Tong, Z. (2020) Sorafenib in the Treatment of Patients with Hepatocellular Carcinoma (HCC) and Microvascular Infiltration: A Systematic Review and Meta-Analysis. Journal of International Medical Research, 48, 1-10. [Google Scholar] [CrossRef] [PubMed]