摘要
肝硬化基础上发生的门静脉高压是肝细胞癌常见的合并症,也是影响治疗决策及生存预后的关键因素。肝细胞癌的不同治疗方式也会对门静脉压力起着不同的影响。既往文献显示,肝切除术、反复肝动脉化疗栓塞、奥沙利铂化疗、仑伐替尼治疗可导致门静脉压力升高,而索拉非尼、瑞戈非尼则在临床应用和/或动物实验中被证实在短期内发挥降低门静脉压力的作用。新型联合治疗方案,如阿替丽珠单抗联合贝伐珠单抗以及多纳非尼、阿帕替尼、安罗替尼等新上市的肝细胞癌一线或二线治疗靶向药物等对门静脉高压相关并发症如消化道出血等的影响在相关临床试验中也有报道,但对门静脉压力的整体影响尚待研究。
Portal hypertension(PH)on the basis of liver cirrhosis is a common complication of hepatocellular carcinoma(HCC),and it is also a key factor affecting treatment decisions and prognosis.Different treatment modalities for HCC may have different effects on portal venous pressure.Through a literature review,it is concluded that hepatectomy,repeated transcatheter arterial chemoembolization,oxaliplatin chemotherapy,and lenvatinib can lead to the increase in portal venous pressure,while sorafenib and regorafenib have been proved to reduce portal venous pressure within a short term in clinical trials and/or animal experiments.There are also reports on the effect of novel combination treatment regimens(such as atezolizumab combined with bevacizumab)and newly marketed first-line or second-line targeted drugs for HCC(such as donafenib,apatinib,and anlotinib)on portal hypertension-related complications including gastrointestinal bleeding in related clinical trials,but further studies are needed to investigate their overall effect on portal venous pressure.
作者
陈博文
程家敏
张林枝
雷进
高小强
陆荫英
CHEN Bowen;CHENG Jiamin;ZHANG Linzhi;LEI Jin;GAO Xiaoqiang;LU Yinying(Peking University 302 Clinical Medical School,Beijing 100039,China;Senior Department of Hepatology,The Fifth Medical Center of Chinese PLA General Hospital,Beijing 100039,China;Tianjin Medical University Cancer Institute and Hospital,Tianjin 300060,China;Guizhou Medical University Clinical Medical School,Guiyang 550004,China;Guangdong Key Laboratory of Epigenetics,College of Life Sciences and Oceanography,Shenzhen University,Shenzhen 518055,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2022年第7期1658-1661,共4页
Journal of Clinical Hepatology
基金
深圳市科技创新委员会可持续发展专项(KCXFZ202002011006448)。
关键词
癌
肝细胞
肿瘤治疗方案
门静脉压
Carcinoma,Hepatocellular
Antineoplastic Protocols
Portal Pressure
