门静脉癌栓生长特征对食管胃底静脉曲张影响

目的探讨肝癌门静脉癌栓的生长特征、可能机制及对食管胃底静脉曲张程度的影响。方法分析98例肝癌门静脉癌栓的影像学变化，观察癌栓的生长部位、生长方式及内镜下食管胃底静脉曲张程度。同期入院的106例伴有食管胃底静脉曲张肝硬化患者作为对照。结果93．9％的癌栓以主瘤作为基部在肿瘤同侧门静脉内生长，6．1％的癌栓在肿瘤对侧门静脉内生长，癌栓以门静脉壁作为支架逆血流、离心式发展。大多数癌栓患者食管胃底静脉表现为轻度中度曲张，重度曲张均10％以下，与单纯肝硬化食管胃底静脉曲张的比例相吻合。结论门静脉癌栓生长具有离心、同侧发展的特征；癌栓形成可加重门静脉高压，但短期内对食管胃底静脉曲张程度的影响不大。

Growing Features of Tumor thrombus of Portal Vein and Effect on Severity of Gastroesophageal Varices

Objective To observe the growing features of the tumor thrombus of hepatocellular carcinoma and effect on severity of gastroesophageal varices. Methods The imaging features of 98 cases of hepatocellular carcinoma with tumor thrombi were observed by CT scan during Jan. 2004 and Dec. 2008. The developing modes of tumor thrombus and severity of gastroesophageal varices were ana- lysed. Results 93.9 percent of tumor thrombus grew in portal vein on the same side of the lobe of the main tumor, whereas ,6. 1% percent of tumor thrombus developed in the other side of lobe related to the main tumor. The tumor thrombi developed in the portal vein with modes of far - from - heart. There was no difference between patients with portal venous tumor thrombus and liver cirrhosis in severity of gas- troesophageal varices. Conclusion The features of tumor thrombus were far - from - heart. Heart, which possible cause lies in absorpition nutrition from portal vein. Tumor thrombus of portal vein can add portal vein hypertension but tumor thrombus of portal vein has little effect on severity of gastroe- sophageal varices in short time.