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, 刘作金. 肝癌合并门静脉癌栓形成机制及治疗方法. 国际外科学杂志, 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.	程树群, 李楠, 吴孟超. 门静脉癌栓分型与治疗选择. 中国普外基础与临床杂志, 2012, 19(3): 240-242.
7.	程树群, 吴孟超. 肝癌门静脉癌栓治疗进展. 上海: 第二军医大学出版社, 2008: 152-160.
8.	翁敬飚, 阮海兰, 韦玲, 等. 原发性肝癌并发门静脉癌栓临床探讨. 重庆医学, 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. 现代诊断与治疗, 2014, 25(5): 1147-1148.
13.	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. 中外医学研究, 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, 范维鹏, 李世维. MSCT 诊断肝癌并门静脉癌栓及其在介入治疗中的价值. 中国医疗前沿, 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.	徐立锋, 李国华, 鱼汀, 等. 多层螺旋 CT 对肝细胞癌合并门静脉癌栓的诊断价值. 现代医用影像, 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.	张修平, 王康, 程树群. 原发性肝细胞癌合并门静脉癌栓非手术治疗进展. 中国实用外科杂志, 2016, 36(6): 101-104.
24.	黄克勇, 丁汇清, 李长城, 等. 肝癌导致门静脉癌栓的 ADC 和 DWI 表现和诊断价值. 中国医学影像学杂志, 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, 刘秀颀, 李海月, 等. 磁共振门静脉成像对肝癌门静脉癌栓的诊断价值与临床应用. 河北医药, 2015, 37(3): 393-394.
28.	程树群, 杨甲梅, 沈锋, 等. 肝细胞癌合并门静脉癌栓多学科诊治——东方肝胆外科医院专家共识. 中华肝胆外科杂志, 2015, 21 (9): 582-590.
29.	任杰, 曾婕, 吕艳, 等. 超声造影、常规超声、增强 CT 鉴别诊断门静脉癌栓与血栓的比较. 中华超声影像学杂志, 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.	刘建民, 杨林, 江山岳, 等. 肝细胞癌门静脉癌栓致门静脉海绵样变性侧支循环的影像特征探讨. 西部医学, 2011, 23(11): 2240-2242.
35.	黄斌. 螺旋 CT 和 DSA 诊断肝细胞癌合并肝动脉-门静脉分流及癌栓的诊断对照分析. 中国医学影像学杂志, 2009, 17(2): 127-131.
36.	全国肝癌合并癌栓诊治研究协作组. 肝细胞癌合并门静脉癌栓多学科诊治中国专家共识(2016 版). 中华消化外科杂志, 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, 刘作金. 肝癌合并门静脉癌栓形成机制及治疗方法. 国际外科学杂志, 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. 程树群, 李楠, 吴孟超. 门静脉癌栓分型与治疗选择. 中国普外基础与临床杂志, 2012, 19(3): 240-242.
7. 程树群, 吴孟超. 肝癌门静脉癌栓治疗进展. 上海: 第二军医大学出版社, 2008: 152-160.
8. 翁敬飚, 阮海兰, 韦玲, 等. 原发性肝癌并发门静脉癌栓临床探讨. 重庆医学, 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. 现代诊断与治疗, 2014, 25(5): 1147-1148.
13. 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. 中外医学研究, 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, 范维鹏, 李世维. MSCT 诊断肝癌并门静脉癌栓及其在介入治疗中的价值. 中国医疗前沿, 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. 徐立锋, 李国华, 鱼汀, 等. 多层螺旋 CT 对肝细胞癌合并门静脉癌栓的诊断价值. 现代医用影像, 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. 张修平, 王康, 程树群. 原发性肝细胞癌合并门静脉癌栓非手术治疗进展. 中国实用外科杂志, 2016, 36(6): 101-104.
24. 黄克勇, 丁汇清, 李长城, 等. 肝癌导致门静脉癌栓的 ADC 和 DWI 表现和诊断价值. 中国医学影像学杂志, 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, 刘秀颀, 李海月, 等. 磁共振门静脉成像对肝癌门静脉癌栓的诊断价值与临床应用. 河北医药, 2015, 37(3): 393-394.
28. 程树群, 杨甲梅, 沈锋, 等. 肝细胞癌合并门静脉癌栓多学科诊治——东方肝胆外科医院专家共识. 中华肝胆外科杂志, 2015, 21 (9): 582-590.
29. 任杰, 曾婕, 吕艳, 等. 超声造影、常规超声、增强 CT 鉴别诊断门静脉癌栓与血栓的比较. 中华超声影像学杂志, 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. 刘建民, 杨林, 江山岳, 等. 肝细胞癌门静脉癌栓致门静脉海绵样变性侧支循环的影像特征探讨. 西部医学, 2011, 23(11): 2240-2242.
35. 黄斌. 螺旋 CT 和 DSA 诊断肝细胞癌合并肝动脉-门静脉分流及癌栓的诊断对照分析. 中国医学影像学杂志, 2009, 17(2): 127-131.
36. 全国肝癌合并癌栓诊治研究协作组. 肝细胞癌合并门静脉癌栓多学科诊治中国专家共识(2016 版). 中华消化外科杂志, 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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