|Table of Contents|

Early diagnosis of portal vein tumor thrombus in hepatocellular carcinoma

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2025 01
Page:
142-148
Research Field:
Publishing date:

Info

Title:
Early diagnosis of portal vein tumor thrombus in hepatocellular carcinoma
Author(s):
WANG Huan1; CHENG Shuqun2
1.The First Clinical Medical College of Guangdong Pharmaceutical University,Guangdong Guangzhou 510000,China;2.The Third Affiliated Hospital of Naval Medical University,Shanghai 200438,China.
Keywords:
hepatocellular carcinoma; portal vein tumor thrombus; imaging diagnosis; biomarkers; early diagnosis
PACS:
R730.4
DOI:
10.3969/j.issn.1672-4992.2025.01.023
Abstract:
Hepatocellular carcinoma (HCC) is the most common primary liver cancer worldwide and one of the most common malignancies in patients with chronic liver disease.When diagnosed at an advanced stage,it is usually associated with portal vein tumor thrombus (PVTT),which severely affects patient prognosis.Therefore,early detection of PVTT is crucial for the prognosis of patients with hepatocellular carcinoma.PVTT prediction model is an important tool for rapid identification of high-risk individuals with HCC combined with PVTT.Color Doppler ultrasound (CDUS) and ultrasonography (CEUS) are noninvasive and easily reproducible methods that provide real-time information on the dynamics of portal venous flow.Computed tomography (CT) and magnetic resonance imaging (MRI) are the main diagnostic tools that play an important role in the differential diagnosis of benign versus malignant thrombus.Through the above diagnostic modalities as well as the use of biological markers,the early and accurate diagnosis of HCC combined with PVTT can be realized and the goal of early treatment can be achieved.

References:

［1］ BRAY F,LAVERSANNE M,SUNG H,et al.Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries［J］.CA Cancer J Clin,2024,74(3):229-263.
［2］ MALUCCIO M,COVEY A.Recent progress in understanding,diagnosing,and treating hepatocellular carcinoma［J］.CA Cancer J Clin,2012,62(6):394-399.
［3］ TAKIZAWA D,KAKIZAKI S,SOHARA N,et al.Hepatocellular carcinoma with portal vein tumor thrombosis:clinical characteristics,prognosis,and patient survival analysis［J］.Digestive Diseases and Sciences,2007,52(11):3290-3295.
［4］ ZHU P,LIAO Y,FAN J,et al.Preoperative prediction of hepatocellular carcinoma with portal vein tumor thrombus based on conventional data［J］.Oncotarget,2017,8(61):104227-104237.
［5］ 林美龙,王文强,李剑,等.叶酸受体阳性循环肿瘤细胞检测对肝细胞癌病人合并血管侵犯的诊断价值［J］.临床外科杂志,2022,30(04):364-367. LIN ML,WANG WQ,LI J,et al.The diagnostic value of folate receptor-positive circulating tumor cells detectionin patients with hepatocellular carcinoma with vascular invasion［J］.Journal of Clinical Surgery,2022,30(04):364-367.
［6］ IKAI I,ARII S,OKAZAKI M,et al.Report of the 17th nationwide follow-up survey of primary liver cancer in Japan［J］.Hepatology Research,2007,37(9):676-691.
［7］ CHEN H,TURON F,HERNANDEZ-GEA V,et al.Nontumoral portal vein thrombosis in patients awaiting liver transplantation［J］.Liver Transplantation,2016,22(3):352-365.
［8］ 李玉兰,李学礼,刘蜻蜻.超声在肝癌门静脉癌栓诊断中的价值［J］.现代医药卫生,2013,29(02):259-260. LI YL,LI XL,LIU QQ.The value of ultrasound in the diagnosis of portal vein thrombosis in hepatocellular carcinoma［J］.Journal of Modern Medicine & Health,2013,29(02):259-260.
［9］ 江爱香.彩色多普勒超声诊断原发性肝癌并门静脉癌栓的临床特点分析［J］.现代诊断与治疗,2014,25(05):1147-1148. JIANG AX.Analysis of clinical characteristics of primary hepatocellular carcinoma with portal vein thrombus diagnosed by color Doppler ultrasound［J］.Modern Diagnosis and Treatment,2014,25(05):1147-1148.
［10］ 张晓龙,贡桂英.彩色多普勒超声诊断原发性肝癌并门静脉癌栓的临床特点研究［J］.世界最新医学信息文摘,2018,18(30):176-177. ZHANG XL,GONG GY.A study on the clinical characteristics of primary hepatocellular carcinoma with portal vein thrombus diagnosed by color Doppler ultrasound［J］.World Latest Medicine Information,2018,18(30):176-177.
［11］ 茆占湖,杨波,孙志先,等.肝细胞癌伴门静脉癌栓的临床诊断及治疗分析［J］.中外医学研究,2015,13(29):80-82. MAO ZH,YANG B,SUN ZX,et al.Clinical diagnosis and therapeutic analysis of hepatocellular carcinoma with portal vein thrombosis［J］.Chinese and Foreign Medical Research,2015,13(29):80-82.
［12］ TANAKA K,NUMATA K,OKAZAKI H,et al.Diagnosis of portal vein thrombosis in patients with hepatocellular carcinoma:efficacy of color Doppler sonography compared with angiography［J］.American Journal of Roentgenology,1993,160(6):1279-1283.
［13］ LENCIONI R,CARAMELLA D,SANGUINETTI F,et al.Portal vein thrombosis after percutaneous ethanol injection for hepatocellular carcinoma:value of color Doppler sonography in distinguishing chemical and tumor thrombi［J］.American Journal of Roentgenology,1995,164(5):1125-1130.
［14］ CHEN J,ZHU J,ZHANG C,et al.Contrast-enhanced ultrasound for the characterization of portal vein thrombosis vs tumor-in-vein in HCC patients:a systematic review and meta-analysis［J］.European Radiology,2020,30(5):2871-2880.
［15］ European Association for the Study of the Liver.EASL clinical practice guidelines:Vascular diseases of the liver［J］.Journal of Hepatology,2016,64(1):179-202.
［16］ CLAUDON M,DIETRICH CF,CHOI BI,et al.Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver-update 2012:a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB,AIUM,ASUM,FLAUS and ICUS［J］.Ultraschall in der Medizin,2013,34(1):11-29.
［17］ SOFIA C,CATTAFI A,SILIPIGNI S,et al.Portal vein thrombosis in patients with chronic liver diseases:From conventional to quantitative imaging［J］.European Journal of Radiology,2021,142:109859.
［18］ TARANTINO L,FRANCICA G,SORDELLI I,et al.Diagnosis of benign and malignant portal vein thrombosis in cirrhotic patients with hepatocellular carcinoma:color Doppler US,contrast-enhanced US,and fine-needle biopsy［J］.Abdominal Imaging,2006,31(5):537-544.
［19］ RICCI P,CANTISANI V,BIANCARI F,et al.Contrast-enhanced color Doppler US in malignant portal vein thrombosis［J］.Acta Radiologica,2000,41(5):470-473.
［20］ LI H,LIU J,CHEN M,et al.Therapeutic evaluation of radiotherapy with contrast-enhanced ultrasound in non-resectable hepatocellular carcinoma patients with portal vein tumor thrombosis［J］.Medical Science Monitor,2018,24:8183-8189.
［21］ 秦秀.螺旋CT三期增强扫描对原发性肝癌合并门静脉癌栓的诊断价值［J］.中国CT和MRI杂志,2020,18(03):24-26. QIN X.Diagnostic value of helical CT three phase enhanced scanning in primary hepatocellular carcinoma with portal vein tumor thrombus［J］.Chinese Journal of CT and MRI,2020,18(03):24-26.
［22］ 黄光辉.螺旋CT三期增强扫描对原发性肝癌合并门静脉癌栓诊断效能分析［J］.中国医学创新,2021,18(27):136-140. HUANG GH.Analysis of spiral CT phase Ⅲ enhanced scan in the diagnosis efficacy of primary hepatic carcinoma complicated with portal venous thromboembolism［J］.Medical Innovation of China,2021,18(27):136-140.
［23］ 邵翠贞,叶海琪,李恩泽,等.多层螺旋CT在肝癌合并门静脉癌栓中的临床应用价值［J］.肝胆胰外科杂志,2021,33(12):755-757. SHAO CZ,YE HQ,LI EZ,et al.The clinical value of multi-slice spiral CT in hepatocellular carcinoma complicated with portal vein tumor thrombus［J］.Journal of Hepatopancreatobiliary Surgery,2021,33(12):755-757.
［24］ 王勇,万杨莉.MSCT诊断肝癌并门静脉癌栓及其在介入治疗中的价值［J］.现代医用影像学,2023,32(10):1928-1930,1934. WANG Y,WAN YL.Diagnosis of hepatocellular carcinoma with portal vein thrombus by MSCT and its value in interventional therapy［J］.Modern Medical Imageology,2023,32(10):1928-1930,1934.
［25］ HU S,ZHANG J,CHENG C,et al.The role of 18F-FDG PET/CT in differentiating malignant from benign portal vein thrombosis［J］.Abdominal Imaging,2014,39(6):1221-1227.
［26］ WU B,ZHANG Y,TAN H,et al.Value of (18)F-FDG PET/CT in the diagnosis of portal vein tumor thrombus in patients with hepatocellular carcinoma［J］.Abdominal Radiology,2019,44(7):2430-2435.
［27］ 李宏,徐小虎,彭进,等.CT门静脉造影三维重建诊断门静脉癌栓的价值［J］.中国CT和MRI杂志,2022,20(12):101-102. LI H,XU XH,PENG J,et al.Value of three-dimensional reconstruction of CT arterial portography in the diagnosis of portal vein tumor thrombi［J］.Chinese Journal of CT and MRI,2022,20(12):101-102.
［28］ LI C,HU J,ZHOU D,et al.Differentiation of bland from neoplastic thrombus of the portal vein in patients with hepatocellular carcinoma:application of susceptibility-weighted MR imaging［J］.BMC Cancer,2014,14:590.
［29］ ICHIKAWA S,GOSHIMA S.Gadoxetic acid-enhanced liver MRI:Everything you need to know［J］.Investigative Radiology,2024,59(1):53-68.
［30］ BAE JS,LEE JM,YOON JH,et al.How to best detect portal vein tumor thrombosis in patients with hepatocellular carcinoma meeting the Milan criteria:Gadoxetic acid-enhanced MRI versus contrast-enhanced CT［J］.Liver Cancer,2020,9(3):293-307.
［31］ KIM JH,LEE JM,YOON JH,et al.Portal vein thrombosis in patients with hepatocellular carcinoma:Diagnostic accuracy of gadoxetic acid-enhanced MR imaging［J］.Radiology,2016,279(3):773-783.
［32］ LIU Y,WANG X,JIANG K,et al.The diagnostic value of tumor biomarkers for detecting hepatocellular carcinoma accompanied by portal vein tumor thrombosis［J］.Cell Biochemistry and Biophysics,2014,69(3):455-459.
［33］ LI D,MALLORY T,SATOMURA S.AFP-L3:a new generation of tumor marker for hepatocellular carcinoma［J］.Clinica Chimica Acta 2001,313(1-2):15-19.
［34］ MIYAAKI H,NAKASHIMA O,KUROGI M,et al.Lens culinaris agglutinin-reactive alpha-fetoprotein and protein induced by vitamin K absence II are potential indicators of a poor prognosis:a histopathological study of surgically resected hepatocellular carcinoma［J］.Journal of Gastroenterology,2007,42(12):962-968.
［35］ 陈祖华,陈瑶,高智峰,等.肝细胞癌合并门静脉癌栓与AFP-L3%相关性研究［J］.医学研究杂志,2012,41(07):113-116. CHEN ZH,CHEN Y,GAO ZF,et.al.Correlation between Lens culinaris agglutinin-reactive A-fetoprotein (AFP-13%) with portal vein tumor thrombosis in hepatocellular carcinoma［J］.Journal of Medical Research,2012,41(07):113-116.
［36］ OKUDA H,NAKANISHI T,TAKATSU K,et al.Clinicopathologic features of patients with hepatocellular carcinoma seropositive for alpha-fetoprotein-L3 and seronegative for des-gamma-carboxy prothrombin in comparison with those seropositive for des-gamma-carboxy prothrombin alone［J］.Journal of Gastroenterology and Hepatology,2002,17(7):772-778.
［37］ TADA T,KUMADA T,TOYODA H,et al.Relationship between Lens culinaris agglutinin-reactive alpha-fetoprotein and pathologic features of hepatocellular carcinoma［J］.Liver International,2005,25(4):848-853.
［38］ 童敬澍,马浙平,毛书奇,等.异常凝血酶原对肝癌合并门静脉癌栓的预测价值［J］.肝胆胰外科杂志,2022,34(01):23-29. TONG JS,MA ZP,MAO SQ,et al.Prediction value of PIVKA-Ⅱ for hepatocellular carcinoma complicated with portalvein tumor thrombosis［J］.Journal of Hepatopancreatobiliary Surgery,2022,34(01):23-29.
［39］ GIBADULINOVA A,TOTHOVA V,PASTOREK J,et al.Transcriptional regulation and functional implication of S100P in cancer［J］.Amino Acids,2011,41(4):885-892.
［40］ ARUMUGAM T,SIMEONE DM,VAN GOLEN K,et al.S100P promotes pancreatic cancer growth,survival,and invasion［J］.Clinical Cancer Research,2005,11(15):5356-5364.
［41］ QI LN,MA L,WU FX,et al.S100P as a novel biomarker of microvascular invasion and portal vein tumor thrombus in hepatocellular carcinoma［J］.Hepatology International,2021,15(1):114-126.
［42］ SUEHIRO T,SHIMADA M,MATSUMATA T,et al.Thrombomodulin inhibits intrahepatic spread in human hepatocellular carcinoma［J］.Hepatology,1995,21(5):1285-1290.
［43］ ZHOU J,TANG ZY,FAN J,et al.The potential of plasma thrombomodulin as a biomarker of portal vein tumor thrombus in hepatocellular carcinoma［J］.Journal of Cancer Research and Clinical Oncology,2001,127(9):559-564.
［44］ YAMADA T,SATO K,KOMACHI M,et al.Lysophosphatidic acid (LPA) in malignant ascites stimulates motility of human pancreatic cancer cells through LPA1［J］.The Journal of Biological Chemistry,2004,279(8):6595-6605.
［45］ 解长佶,胡超,曹凯,等.原发性肝癌患者血浆溶血磷脂酸的临床意义［J］.中国医学创新,2016,13(31):13-16. XIE CJ,HU C,CAO K,et al.Significance of plasma lysophosphatidic acid detection in patients with primary liver cancer［J］.Medical Innovation of China,2016,13(31):13-16.

Memo

Memo:
国家重点研发计划项目（编号：2022YFC2503700）；上海市重中之重-肝胆临床研究中心项目（编号：2023ZZ02005）
Last Update: 1900-01-01