Hepatocellular carcinoma (HCC) is a frequent complication of various liver diseases, occurring with or without underlying cirrhosis. While cirrhosis and chronic liver inflammation are well-established major drivers of hepatocarcinogenesis, HCC can also develop in patients with vascular liver diseases (VLDs), highlighting an alternative pathway of disease progression. Alterations in liver perfusion appear to underlie the process of carcinogenesis. However, the specific molecular mechanisms involved in this process as well as the clinical presentation and imaging features of HCC in the most common VLDs are still a matter of debate. This review aims to evaluate the available literature on the topic to provide a deeper comprehension and analysis of current knowledge about the relation between VLDs and HCC. Specifically, we investigate how HCC affects VLDs such as Budd–Chiari syndrome, Fontan-associated liver disease, congenital portosystemic shunts, cavernous transformation of the portal vein, and porto-sinusoidal vascular disorder. Exploring the pathogenetic mechanisms and diagnostic challenges in HCC related to VLDs may have important therapeutic implications, helping to define targeted treatments for this poorly understood medical entity.
肝细胞癌（HCC）是多种肝脏疾病的常见并发症，可在伴有或不伴有潜在肝硬化的背景下发生。尽管肝硬化和慢性肝脏炎症已被公认为肝癌发生的主要驱动因素，但HCC也可在血管性肝病患者中发展，这揭示了疾病进展的另一种途径。肝脏灌注改变似乎是癌变过程的基础。然而，这一过程中涉及的具体分子机制，以及最常见血管性肝病中HCC的临床表现和影像学特征，目前仍存在争议。本综述旨在评估该主题的现有文献，以更深入地理解和分析当前关于血管性肝病与HCC关系的认知。具体而言，我们探讨了HCC如何影响布加综合征、Fontan相关性肝病、先天性门体分流、门静脉海绵样变及门静脉-肝窦血管性疾病等血管性肝病。探索与血管性肝病相关的HCC的发病机制和诊断挑战可能具有重要的治疗意义，有助于为这一认知尚浅的医学实体制定靶向治疗方案。
Role of Vascular Liver Diseases in Hepatocellular Carcinoma Development
肿瘤(癌症)患者之家