HVPG signature: A prognostic and predictive tool in hepatocellular carcinoma
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Xiaolong Qi1,*, Xin Zhang2,*, Zhijia Li1,*, Jialiang Hui1,*, Yi Xiang1, Jinjun Chen3, Jianbo Zhao4, Jing Li5, Fu-Zhen Qi6 and Yong Xu7
1 Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
2 Department of Radiology, the Fourth People’s Hospital of Huai’an, Huai’an, China
3 Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
4 Department of Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
5 Department of Gastroenterology, Tongji Hospital of Tongji University, Shanghai, China
6 Department of Hepatopancreatobiliary Surgery, Huai’an First People’s Hospital, Nanjing Medical University, Huai’an, China
7 Department of Nephrology, The Affiliated Huai’an Hospital of Xuzhou Medical University and The Second People’s Hospital of Huai’an, Huai’an, China
* These authors have contributed equally to this work
Fu-Zhen Qi, email:
Yong Xu, email:
Keywords: hepatic venous pressure gradient, hepatocellular carcinoma, prognosis, prediction, hepatic resection
Received: May 20, 2016 Accepted: August 13, 2016 Published: August 23, 2016
Hepatic venous pressure gradient (HVPG) measurement provides independent prognostic value in patients with cirrhosis, and the prognostic and predictive role of HVPG in hepatocellular carcinoma (HCC) also has been explored. The management of HCC is limited to the European Association for the Study of the Liver (EASL) and American Association for the Study of Liver Diseases (AASLD) guidelines that consider that HVPG≥10 mmHg to be a contraindication for hepatic resection (HR), otherwise other treatment modalities are recommended. Current studies show that a raised HVPG diagnosed directly or indirectly leads to a negative prognosis of patients with HCC and cirrhosis, but HVPG greater than 10 mmHg should not be regarded as an absolute contraindication for HR. Selecting direct or surrogate measurement of HVPG is still under debate. Only several studies reported the impact of HVPG in negative prognosis of HCC patients after liver transplantation (LT) and the value of HVPG in the prediction of HCC development, which need to be further validated.
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