TY - JOUR
T1 - Macroscopic Portal Vein Thrombosis in HCC Patients
AU - Akkiz, Hikmet
AU - Carr, Brian I
AU - Kuran, Sedef
AU - Karaoğullarından, Ümit
AU - Üsküdar, Oguz
AU - Tokmak, Salih
AU - Arslan, Burcu
AU - Doran, Figen
AU - Balli, Hüseyin Tugsan
AU - Ülkü, Abdulalh
AU - Akçam, Tolga Atılgan
AU - Bahçeci, Halil İbrahim
AU - Polat, Kamil Yalçın
AU - Örmeci, Necati
AU - Şimşek, Halis
AU - Sonsuz, Abdullah
AU - Demir, Ali
AU - Altıntaş, Engin
AU - Demir, Mehmet
AU - Yalçın, Kendal
AU - Ekinci, Nazım
AU - Harmancı Özakyol, Ayşegül
AU - Yücesoy, Mehmet
AU - Uygun, Ahmet
AU - Guerra, Vito
AU - Delik, Anıl
AU - Tokat, Yaman
AU - Yilmaz, Sezai
AU - Bektaş, Ahmet
AU - Kılıç, Murat
PY - 2018
Y1 - 2018
N2 - Macroscopic portal vein invasion (PVT) by hepatocellular carcinoma (HCC) in the liver is one of the most important negative prognostic factors for HCC patients. The characteristics of a large cohort of such patients were examined. We found that the percent of patients with PVT significantly increased with increasing maximum tumor diameter (MTD), from 13.7% with tumors of MTD <5cm to 56.4% with tumors of MTD >10cm. There were similar numbers of HCC patients with very large tumors with and without PVT. Thus, MTD alone was insufficient to explain the presence of PVT, as were high AFP levels, since less than 50% of high AFP patients had PVT. However, the percent of patients with PVT was also found to significantly increase with increasing blood alpha-fetoprotein (AFP) levels and tumor multifocality. A logistic regression model that included these 3 factors together showed an odds ratio of 17.9 for the combination of MTD>5.0cm plus tumor multifocality plus elevated AFP, compared to low levels of these 3 parameters. The presence or absence of macroscopic PVT may therefore represent different HCC aggressiveness phenotypes, as judged by a significant increase in tumor multifocality and AFP levels in the PVT positive patients. Factors in addition to MTD and AFP must also contribute to PVT development.
AB - Macroscopic portal vein invasion (PVT) by hepatocellular carcinoma (HCC) in the liver is one of the most important negative prognostic factors for HCC patients. The characteristics of a large cohort of such patients were examined. We found that the percent of patients with PVT significantly increased with increasing maximum tumor diameter (MTD), from 13.7% with tumors of MTD <5cm to 56.4% with tumors of MTD >10cm. There were similar numbers of HCC patients with very large tumors with and without PVT. Thus, MTD alone was insufficient to explain the presence of PVT, as were high AFP levels, since less than 50% of high AFP patients had PVT. However, the percent of patients with PVT was also found to significantly increase with increasing blood alpha-fetoprotein (AFP) levels and tumor multifocality. A logistic regression model that included these 3 factors together showed an odds ratio of 17.9 for the combination of MTD>5.0cm plus tumor multifocality plus elevated AFP, compared to low levels of these 3 parameters. The presence or absence of macroscopic PVT may therefore represent different HCC aggressiveness phenotypes, as judged by a significant increase in tumor multifocality and AFP levels in the PVT positive patients. Factors in addition to MTD and AFP must also contribute to PVT development.
U2 - 10.1155/2018/3120185
DO - 10.1155/2018/3120185
M3 - Article
C2 - 30009156
VL - 2018
SP - 3120185
JO - Canadian Journal of Gastroenterology and Hepatology
JF - Canadian Journal of Gastroenterology and Hepatology
SN - 2291-2789
ER -