Frontiers in Genetics · 8 authors, 4 centres
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This narrative review synthesizes existing literature to propose that circulating tumor cells (CTCs) play a central role in the formation of microvascular invasion (MVI) in hepatocellular carcinoma (HCC). It suggests this mechanism could lead to new predictive models and targeted therapies.
This narrative review discusses the role of circulating tumor cells (CTCs) in the formation of microvascular invasion (MVI) and portal vein tumor thrombus (PVTT) in hepatocellular carcinoma (HCC), which are major risk factors for postoperative recurrence. The authors review current understanding of MVI formation, proposing that CTCs shed into the bloodstream may adhere to vascular endothelium and proliferate to form tumor thrombi. They discuss mechanisms involving interactions between CTCs and components like platelets, coagulation factors, and immune cells in the tumor microenvironment, which may facilitate adhesion and resistance to apoptosis. The review concludes by suggesting that a CTC-based mechanism could inform new predictive models for MVI risk and combination therapies targeting the tumor microenvironment. As a review, it does not report original empirical data; its implications are theoretical and based on synthesizing prior clinical and preclinical research.
