肝细胞癌合并门静脉癌栓的治疗现状及进展

Current treatment and progress of hepatocellular carcinoma with portal vein tumor thrombus

门静脉癌栓是影响肝细胞癌患者预后的重要因素之一.手术治疗、介入治疗、放疗、局部毁损治疗、靶向治疗在门静脉癌栓形成的治疗中各有特点,但效果均不理想.目前国内外学者正在探索采用多种治疗模式治疗门静脉癌栓,以其达到更好的效果.以手术为主的综合治疗可以切除肿瘤和癌栓,改善患者肝脏功能,提高生存质量,延长生存时间;但手术风险大、创伤大;以非手术为主的综合治疗具有创伤小、风险小,能够提高癌栓的局部控制的优点;但有效率低,不能达到根治,缓解期短,效果不佳.因此,应该根据不同的癌栓分型选择不同的治疗模式,探索最佳治疗模式组合.

Portal venous tumor emboli is one of the important factors that affect the prognosis of patients with hepatocellular carcinoma （HCC）.There are different characters of surgery,interventional therapy,radiation therapy,treatment of local damage,targeted therapy in the treatment of portal venous tumor emboli,but the effects are not ideal.Scholars at home and abroad are exploring a variety of treatment patterns in the treatment of portal venous tumor emboli,to achieve better effect.Predominantly surgical comprehensive treatment can excision of tumor and tumor emboli,improve liver function,improve the quality of survival,prolong survival time.But the operation risk is big.Mainly non-surgical treatment has advantages of little trauma,less risk,and better local control of tumor emboli.But the efficiency,effect,alleviate period is ineffective.Therefore,the best treatment mode should be explored according to the different tumor emboli parting.