肝细胞癌合并门静脉癌栓的转化治疗现况与进展  

Conversion therapy for hepatocellular carcinoma complicated with portal vein tumor thrombus:current status and progress

作　　者：田淏 刘俊杰 沈皓 夏勇 沈锋 TIAN Hao;LIU Junjie;SHEN Hao;XIA Yong;SHEN Feng(The First Clinical Medical College,Guangdong Pharmaceutical University,Guangzhou 510006,Guangdong,China;Department of Hepatic Surgery(Ⅳ),The Third Affiliated Hospital of Naval Medical University(Second Military MedicalUniversity),Shanghai 200438,China;Clinical Research Institute,The Third Affiliated Hospital of Naval Medical University(Second Military Medical University),Shanghai 200438,China)

机构地区：[1]广东药科大学第一临床医学院,广州510006 [2]海军军医大学(第二军医大学)第三附属医院肝外四科,上海200438 [3]海军军医大学(第二军医大学)第三附属医院临床研究院,上海200438

出　　处：《海军军医大学学报》2025年第2期182-188,共7页Academic Journal of Naval Medical University

基　　金：国家资助博士后人员项目(GZC20231943);上海市申康医院发展中心示范性研究型病房建设项目(SHDC2023CRW002).

摘　　要：肝细胞癌(HCC)的生物学特性导致门静脉癌栓高发,其病情发展迅速,短期内可丧失根治性手术切除的机会,致使患者预后极差。通过对不可切除的HCC合并门静脉癌栓患者进行合理的降期治疗,达到可切除的范畴是目前研究的热点。本文综述了HCC合并门静脉癌栓转化治疗的潜在目标人群,并分析肝动脉灌注化疗、肝动脉插管化疗栓塞术、放射治疗、区域性及系统药物治疗在HCC转化治疗中的应用,指出联合多学科的综合治疗手段是提升HCC合并门静脉癌栓患者预后的关键。The biological characteristics of hepatocellular carcinoma(HCC)lead to a high incidence of portal vein tumor thrombus.It progresses rapidly,and the opportunity for radical surgical resection can be lost in a short term,resulting in poor prognosis.Reasonable down-staging treatment is a research focus for patients with unresectable HCC complicated with portal vein tumor thrombus to achieve a resectable range.This article reviews the potential population of HCC complicated with portal vein tumor thrombus with conversion therapy for HCC,analyzes the application of hepatic artery infusion chemotherapy,transcatheter arterial chemoembolization,radiotherapy,regional and systemic drug therapy in conversion therapy,and points out that the combination of multidisciplinary comprehensive treatments is the key to improve the prognosis of HCC patients with portal vein tumor thrombus.

关 键 词：肝肿瘤 肝细胞癌 转化治疗 门静脉癌栓 

分 类 号：R735.7[医药卫生—肿瘤]