Updates of diagnosis and differential diagnosis for hepatocellular carcinoma with portal vein tumor thrombus_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Xiuping , LI Nan , WEI Xubiao , LI Shanshan ,  CHENG Shuqun

Department of Hepatic Surgery Ⅵ, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, P.R.China;

Corresponding?author：

CHENG Shuqun, Email: chengshuqun@aliyun.com

Keywords：

hepatocellular carcinoma; portal vein tumor thrombus; diagnosis; differential diagnosis

DOI：

10.7507/1007-9424.201610005

Video：

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Objective To summarize the updates of diagnosis and differential diagnosis for hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) for providing evidences for early diagnosis and treatment of PVTT patients. Methods The related literatures on diagnosis and differential diagnosis for HCC with PVTT in recent years were collected and reviewed. Results The serious complications and tumor metastasis are attributed to the PVTT, then it is necessary to make diagnosis accurately according to clinical symptoms, hematological and imaging examinations. The differential diagnosis of PVTT and portal vein thrombosis, portal sponge degeneration and hepatic arteriovenous shunt diseases should be carried out. Conclusions The diagnosis and differential diagnosis of PVTT cannot rely on a single method, and it requires a comprehensive judgment of various diagnostic methods. More accurate and specific diagnostic methods are needed.

Citation： ZHANG Xiuping, LI Nan, WEI Xubiao, LI Shanshan, CHENG Shuqun. Updates of diagnosis and differential diagnosis for hepatocellular carcinoma with portal vein tumor thrombus. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(4): 507-511. doi: 10.7507/1007-9424.201610005 Copy

1.	Zhang ZM, Lai EC, Zhang C,et al. The strategies for primary hepatocellular carcinoma with portal vein tumor thrombus. Int J Surg, 2015, 20: 8-16.
2.	Yang T, Lin C, Zhai J,et al. Surgical resection for advanced hepatocellular carcinoma according to Barcelona Clinic Liver Cancer (BCLC) staging. J Cancer Res Clin Oncol, 2012, 138(7): 1121-1129.
3.	胡萌宇, 劉作金. 肝癌合并門靜脈癌栓形成機制及治療方法. 國際外科學雜志, 2013, 40(10): 688-691.
4.	Cheng SQ, Wu MC, Chen H,et al. Tumor thrombus types influence the prognosis of hepatocellular carcinoma with the tumor thrombi in the portal vein. Hepatogastroenterology, 2007, 54(74): 499-502.
5.	Shi J, Lai EC, Li N,et al. A new classification for hepatocellular carcinoma with portal vein tumor thrombus. J Hepatobiliary Pancreat Sci, 2011, 18(1): 74-80.
6.	程樹群, 李楠, 吳孟超. 門靜脈癌栓分型與治療選擇. 中國普外基礎與臨床雜志, 2012, 19(3): 240-242.
7.	程樹群, 吳孟超. 肝癌門靜脈癌栓治療進展. 上海: 第二軍醫大學出版社, 2008: 152-160.
8.	翁敬飚, 阮海蘭, 韋玲, 等. 原發性肝癌并發門靜脈癌栓臨床探討. 重慶醫學, 2010, 39(17): 2344-2347.
9.	Manzano-Robleda MC, Barranco-Fragoso B, Uribe M,et al. Portal vein thrombosis: what is new? Ann Hepatol, 2015, 14(1): 20-27.
10.	Bruix J, Reig M, Sherman M. Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma. Gastroenterology, 2016, 150(4): 835-853.
11.	Giorgio A, Calisti G, Montesarchio L,et al. Hepatocellular carcinoma invading portal venous system in cirrhosis: long-term results of percutaneous radiofrequency ablation of both the nodule and portal vein tumor thrombus. A case control study. Anticancer Res, 2014, 34(11): 6785-6790.
12.	江愛香. 彩色多普勒超聲診斷原發性肝癌并門靜脈癌栓的臨床特點分析. 現代診斷與治療, 2014, 25(5): 1147-1148.
13.	茆占湖, 楊波, 孫志先, 等. 肝細胞癌伴門靜脈癌栓的臨床診斷及治療分析. 中外醫學研究, 2015, 13(29): 80-82.
14.	Chen R, Ye S, Fan J,et al. Comparison of the imaging diagnosis for tumor thrombi in the poral vein. Chin J Clini Hepatol, 2006, 22(4): 258-259.
15.	European Association for The Study of the Liver, European Organisation for Research and Treatment Of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol, 2012, 56(4): 908-943.
16.	Bruix J, Sherman M, American Association for the Study of Liver Disease. Management of hepatocellular carcinoma: an update. Hepatology, 2011, 53(3): 1020-1022.
17.	Capussotti L, Ferrero A, Viganb L,et al. Liver resection for HCC with cirrhosis: surgical perspectives out of EASL/AASLD guidelines. Eur J Surg Oncol, 2009, 35(1): 11-15.
18.	Manini MA, Sangiovanni A, Fornari F,et al. Clinical and economical impact of 2010 AASLD guidelines for the diagnosis of hepatoeellalar carcinoma. J Hepatol, 2014, 60(5): 995-1001.
19.	董春玲, 范維鵬, 李世維. MSCT 診斷肝癌并門靜脈癌栓及其在介入治療中的價值. 中國醫療前沿, 2013, 8(4): 80-81.
20.	Yukisawa S, Okugawa H, Masuya Y,et al. Multidetector helical CT plus superparamagnetic iron oxide-enhanced MR imaging for focal hepatic lesions in cirrhotic liver: a comparison with multi-phase CT during hepatic arteriography. Eur J Radiol, 2007, 61(2): 279-289.
21.	徐立鋒, 李國華, 魚汀, 等. 多層螺旋 CT 對肝細胞癌合并門靜脈癌栓的診斷價值. 現代醫用影像, 2014, 23(5): 475-478.
22.	Wei XB, Xu J, Li N,et al. The role of three-dimensional imaging in optimizing diagnosis, classification and surgical treatment of hepatocellular carcinoma with portal vein tumor thrombus. HPB (Oxford), 2016, 18(3): 287-295.
23.	張修平, 王康, 程樹群. 原發性肝細胞癌合并門靜脈癌栓非手術治療進展. 中國實用外科雜志, 2016, 36(6): 101-104.
24.	黃克勇, 丁匯清, 李長城, 等. 肝癌導致門靜脈癌栓的 ADC 和 DWI 表現和診斷價值. 中國醫學影像學雜志, 2015, 23(8): 602-605.
25.	Sandrasegaran K, Tahir B, Nutakki K,et al. Usefulness of conventional MRI sequences and diffusion-weighted imaging in differentiating malignant from benign portal vein thrombus in cirrhotic patients. AJR Am J Roentgenol, 2013, 201(6): 1211-1219.
26.	Catalano OA, Choy G, Zhu A,et al. Differentiation of malignant thrombus from bland thrombus of the portal vein in patients with hepatocellular carcinoma: application of diffusion weighted MR imaging. Radiology, 2010, 254(1): 154-162.
27.	胡建新, 劉秀頎, 李海月, 等. 磁共振門靜脈成像對肝癌門靜脈癌栓的診斷價值與臨床應用. 河北醫藥, 2015, 37(3): 393-394.
28.	程樹群, 楊甲梅, 沈鋒, 等. 肝細胞癌合并門靜脈癌栓多學科診治——東方肝膽外科醫院專家共識. 中華肝膽外科雜志, 2015, 21 (9): 582-590.
29.	任杰, 曾婕, 呂艷, 等. 超聲造影、常規超聲、增強 CT 鑒別診斷門靜脈癌栓與血栓的比較. 中華超聲影像學雜志, 2011, 20(11): 944-946.
30.	Zhang X, Jiang HZ, Zhu LY,et al. Differential diagnosis of portal vein thrombus from cancer embolus by spiral CT enhancement scanning. J Med Imaging, 2015, 25(10): 1812-1814.
31.	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. BMC Cancer, 2014, 14: 590.
32.	Hu S, Zhang J, Cheng C,et al. The role of 18F-FDG PET/CT in differentiating malignant from benign portal vein thrombosis. Abdom Imaging, 2014, 39(6): 1221-1227.
33.	Wang L, Li ZS, Lu JP,et al. Cavernous transformation of the portal vein: three-dimensional dynamic contrast enhanced MR angiography. Abdom Imaning, 2008, 33(4): 463-468.
34.	劉建民, 楊林, 江山岳, 等. 肝細胞癌門靜脈癌栓致門靜脈海綿樣變性側支循環的影像特征探討. 西部醫學, 2011, 23(11): 2240-2242.
35.	黃斌. 螺旋 CT 和 DSA 診斷肝細胞癌合并肝動脈-門靜脈分流及癌栓的診斷對照分析. 中國醫學影像學雜志, 2009, 17(2): 127-131.
36.	全國肝癌合并癌栓診治研究協作組. 肝細胞癌合并門靜脈癌栓多學科診治中國專家共識(2016 版). 中華消化外科雜志, 2016, 15(5): 411-416.
37.	Cheng SQ, Yang JM, Shen F,et al. Multidisciplinary management of hepatocellular carcinoma with portal vein tumor thrombus-Eastern Hepatobiliary Surgical Hospital consensus statement. Oncotarget, 2016, 7(26): 40816-40829.

1. Zhang ZM, Lai EC, Zhang C,et al. The strategies for primary hepatocellular carcinoma with portal vein tumor thrombus. Int J Surg, 2015, 20: 8-16.
2. Yang T, Lin C, Zhai J,et al. Surgical resection for advanced hepatocellular carcinoma according to Barcelona Clinic Liver Cancer (BCLC) staging. J Cancer Res Clin Oncol, 2012, 138(7): 1121-1129.
3. 胡萌宇, 劉作金. 肝癌合并門靜脈癌栓形成機制及治療方法. 國際外科學雜志, 2013, 40(10): 688-691.
4. Cheng SQ, Wu MC, Chen H,et al. Tumor thrombus types influence the prognosis of hepatocellular carcinoma with the tumor thrombi in the portal vein. Hepatogastroenterology, 2007, 54(74): 499-502.
5. Shi J, Lai EC, Li N,et al. A new classification for hepatocellular carcinoma with portal vein tumor thrombus. J Hepatobiliary Pancreat Sci, 2011, 18(1): 74-80.
6. 程樹群, 李楠, 吳孟超. 門靜脈癌栓分型與治療選擇. 中國普外基礎與臨床雜志, 2012, 19(3): 240-242.
7. 程樹群, 吳孟超. 肝癌門靜脈癌栓治療進展. 上海: 第二軍醫大學出版社, 2008: 152-160.
8. 翁敬飚, 阮海蘭, 韋玲, 等. 原發性肝癌并發門靜脈癌栓臨床探討. 重慶醫學, 2010, 39(17): 2344-2347.
9. Manzano-Robleda MC, Barranco-Fragoso B, Uribe M,et al. Portal vein thrombosis: what is new? Ann Hepatol, 2015, 14(1): 20-27.
10. Bruix J, Reig M, Sherman M. Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma. Gastroenterology, 2016, 150(4): 835-853.
11. Giorgio A, Calisti G, Montesarchio L,et al. Hepatocellular carcinoma invading portal venous system in cirrhosis: long-term results of percutaneous radiofrequency ablation of both the nodule and portal vein tumor thrombus. A case control study. Anticancer Res, 2014, 34(11): 6785-6790.
12. 江愛香. 彩色多普勒超聲診斷原發性肝癌并門靜脈癌栓的臨床特點分析. 現代診斷與治療, 2014, 25(5): 1147-1148.
13. 茆占湖, 楊波, 孫志先, 等. 肝細胞癌伴門靜脈癌栓的臨床診斷及治療分析. 中外醫學研究, 2015, 13(29): 80-82.
14. Chen R, Ye S, Fan J,et al. Comparison of the imaging diagnosis for tumor thrombi in the poral vein. Chin J Clini Hepatol, 2006, 22(4): 258-259.
15. European Association for The Study of the Liver, European Organisation for Research and Treatment Of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol, 2012, 56(4): 908-943.
16. Bruix J, Sherman M, American Association for the Study of Liver Disease. Management of hepatocellular carcinoma: an update. Hepatology, 2011, 53(3): 1020-1022.
17. Capussotti L, Ferrero A, Viganb L,et al. Liver resection for HCC with cirrhosis: surgical perspectives out of EASL/AASLD guidelines. Eur J Surg Oncol, 2009, 35(1): 11-15.
18. Manini MA, Sangiovanni A, Fornari F,et al. Clinical and economical impact of 2010 AASLD guidelines for the diagnosis of hepatoeellalar carcinoma. J Hepatol, 2014, 60(5): 995-1001.
19. 董春玲, 范維鵬, 李世維. MSCT 診斷肝癌并門靜脈癌栓及其在介入治療中的價值. 中國醫療前沿, 2013, 8(4): 80-81.
20. Yukisawa S, Okugawa H, Masuya Y,et al. Multidetector helical CT plus superparamagnetic iron oxide-enhanced MR imaging for focal hepatic lesions in cirrhotic liver: a comparison with multi-phase CT during hepatic arteriography. Eur J Radiol, 2007, 61(2): 279-289.
21. 徐立鋒, 李國華, 魚汀, 等. 多層螺旋 CT 對肝細胞癌合并門靜脈癌栓的診斷價值. 現代醫用影像, 2014, 23(5): 475-478.
22. Wei XB, Xu J, Li N,et al. The role of three-dimensional imaging in optimizing diagnosis, classification and surgical treatment of hepatocellular carcinoma with portal vein tumor thrombus. HPB (Oxford), 2016, 18(3): 287-295.
23. 張修平, 王康, 程樹群. 原發性肝細胞癌合并門靜脈癌栓非手術治療進展. 中國實用外科雜志, 2016, 36(6): 101-104.
24. 黃克勇, 丁匯清, 李長城, 等. 肝癌導致門靜脈癌栓的 ADC 和 DWI 表現和診斷價值. 中國醫學影像學雜志, 2015, 23(8): 602-605.
25. Sandrasegaran K, Tahir B, Nutakki K,et al. Usefulness of conventional MRI sequences and diffusion-weighted imaging in differentiating malignant from benign portal vein thrombus in cirrhotic patients. AJR Am J Roentgenol, 2013, 201(6): 1211-1219.
26. Catalano OA, Choy G, Zhu A,et al. Differentiation of malignant thrombus from bland thrombus of the portal vein in patients with hepatocellular carcinoma: application of diffusion weighted MR imaging. Radiology, 2010, 254(1): 154-162.
27. 胡建新, 劉秀頎, 李海月, 等. 磁共振門靜脈成像對肝癌門靜脈癌栓的診斷價值與臨床應用. 河北醫藥, 2015, 37(3): 393-394.
28. 程樹群, 楊甲梅, 沈鋒, 等. 肝細胞癌合并門靜脈癌栓多學科診治——東方肝膽外科醫院專家共識. 中華肝膽外科雜志, 2015, 21 (9): 582-590.
29. 任杰, 曾婕, 呂艷, 等. 超聲造影、常規超聲、增強 CT 鑒別診斷門靜脈癌栓與血栓的比較. 中華超聲影像學雜志, 2011, 20(11): 944-946.
30. Zhang X, Jiang HZ, Zhu LY,et al. Differential diagnosis of portal vein thrombus from cancer embolus by spiral CT enhancement scanning. J Med Imaging, 2015, 25(10): 1812-1814.
31. 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. BMC Cancer, 2014, 14: 590.
32. Hu S, Zhang J, Cheng C,et al. The role of 18F-FDG PET/CT in differentiating malignant from benign portal vein thrombosis. Abdom Imaging, 2014, 39(6): 1221-1227.
33. Wang L, Li ZS, Lu JP,et al. Cavernous transformation of the portal vein: three-dimensional dynamic contrast enhanced MR angiography. Abdom Imaning, 2008, 33(4): 463-468.
34. 劉建民, 楊林, 江山岳, 等. 肝細胞癌門靜脈癌栓致門靜脈海綿樣變性側支循環的影像特征探討. 西部醫學, 2011, 23(11): 2240-2242.
35. 黃斌. 螺旋 CT 和 DSA 診斷肝細胞癌合并肝動脈-門靜脈分流及癌栓的診斷對照分析. 中國醫學影像學雜志, 2009, 17(2): 127-131.
36. 全國肝癌合并癌栓診治研究協作組. 肝細胞癌合并門靜脈癌栓多學科診治中國專家共識(2016 版). 中華消化外科雜志, 2016, 15(5): 411-416.
37. Cheng SQ, Yang JM, Shen F,et al. Multidisciplinary management of hepatocellular carcinoma with portal vein tumor thrombus-Eastern Hepatobiliary Surgical Hospital consensus statement. Oncotarget, 2016, 7(26): 40816-40829.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Updates of diagnosis and differential diagnosis for hepatocellular carcinoma with portal vein tumor thrombus

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