肝细胞癌合并门静脉癌栓的治疗进展

肝细胞癌（hepatocellular carcinoma，HCC）是中国常见恶性肿瘤，其死亡率居恶性肿瘤前列。门静脉癌栓（portal vein tumor thrombosis，PVTT）是HCC常见的临床表现和重要的预后不良因素，HCC合并门静脉癌栓患者的肝功能及体能状态、肿瘤是否可切除、PVTT分型以及有无远处转移是制订治疗决策的重要考虑因素。国内指南和专家共识对部分HCC合并PVTT患者推荐外科手术，而其他多数患者则主要接受系统治疗、介入、放疗等姑息治疗。近年，针对HCC合并PVTT，在可手术切除患者的围手术期治疗、不可切除患者的姑息治疗以及转化治疗方面开展了较多的临床研究和探索，HCC多学科诊疗模式也在临床中提倡并推广。本文回顾了近年HCC合并PVTT的相关文献，就其进展进行综述。 

Research progress in the treatment of hepatocellular carcinoma with portal vein tumor thrombosis

Hepatocellular carcinoma (HCC)—a common malignant carcinoma in China—has a high mortality rate nationwide. Portal vein tumor thrombosis (PVTT) is a common clinical manifestation and a critical poor prognostic factor of HCC. In patients with HCC and PVTT, liver function and physical status, tumor resectability, PVTT classification, and presence of distant metastasis are important considerations during treatment decisions. Domestic guidelines and expert consensus recommend surgery for patients with partial HCC and PVTT, while most other patients mainly receive systematic therapy, interventional therapy, radiotherapy, and other palliative treatments. Recently, many clinical studies and explorations have been conducted on perioperative treatments for patients with resectable HCC and PVTT and palliative and translational treatments for patients with unresectable HCC. The clinical application of multidisciplinary modalities for patients with HCC is also increasingly advocated and promoted. This study reviews the progress in the treatment of HCC with PVTT.