Mechanisms of portal vein tumour thrombus formation and development in patients with hepatocellular carcinoma

Abstract

Hepatocellular carcinoma (HCC) is one of the most common and aggressive human malignancies worldwide. Portal vein tumour thrombus (PVTT) is considered one of most fearful complications of HCC and is strongly associated with a poor prognosis. Clarification of the mechanisms underlying the formation and development of PVTT is crucial for developing novel therapeutic strategies for HCC patients. Several studies have been made to uncover that tumour microenvironment, stem cells, abnormal gene expression and non‐coding RNAs deregulation are associated with PVTT in patients with HCC in the last decade. However, the exact molecular mechanisms of PVTT in patients with HCC are still largely unknown. In the present review, we briefly summarized the molecular mechanisms underlying the formation and development of PVTT in HCC.

Case report: Rapid development of acute symptomatic portal vein system thrombosis after endoscopic variceal therapy in a patient with liver cirrhosis

“…Cancer itself can also cause the hypercoagulability in this patient, leading to a higher incidence of PVT ( 20 ). In patients with HCC, the development of PVT might be associated with various causes, including direct tumor compression, tumor secondary hypoxia, and circulating tumor cells ( 21 ). Furthermore, tumors can increase inflammatory factors, such as tumor necrosis factor α, posing this patient at a hypercoagulable state ( 20 , 22 ).…”

Construction of a prognostic model for hepatocellular carcinoma patients receiving transarterial chemoembolization treatment based on the Tumor Burden Score

“…To our knowledge, our study was the first to incorporate TBS into the TACE treatment prognosis model for HCC, providing solid evidence that TBS has good discrimination ability as a tumor burden indicator. PVI and tumor extension represent the invasiveness of tumor biology [ 36 – 39 ]. Unlike other prognostic models for solid tumors, liver reserve function plays an important role in disease analysis and prognosis of patients.…”

Advancements in hepatocellular carcinoma management: the role of 18F-FDG PET-CT in diagnosing portal vein tumor thrombosis

“…In hepatocarcinoma, there is a progressive sequence of portal vein malignant thrombotic events. These successive stages implicate migration and vascular seeding of cancer cells, favored by the tumoral microenvironment, loss of protective mechanisms against hypoxia, and dysregulated genomic processes [25,26].…”

“…Complex mechanisms are involved in the malignant metastasis of HCC in the portal vein. The tumor microenvironment implies a modified extracellular matrix and, alongside hypoxia, leads to the remodeling of endothelial vascular cells and the EMT process [25]. HIF-1α is a transcription factor that regulates the microenvironment in an oxygen-depletion situation and favors metastasis through the EMT pathway [28].…”