Global epidemiology of NAFLD-related HCC: trends, predictions, risk factors and prevention.
Global epidemiology of NAFLD-related HCC: trends, predictions, risk factors and prevention.
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DOI：
10.1038/s41575-020-00381-6
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Loomba R
中科院分区：
文献类型：
--
作者：
Huang DQ;El-Serag HB;Loomba R
据估计，全球四分之一的人口患有非酒精性脂肪肝（NAFLD）。非酒精性脂肪性肝炎（NASH）的发病率预计将在未来10年内增加56%。在美国、法国和英国，NAFLD已经是肝细胞癌（HCC）增长最快的原因。在全球范围内，NAFLD相关HCC的患病率可能会随着肥胖流行的日益增长而增加。在NASH肝硬化患者中，HCC的估计年发病率范围为0.5%至2.6%。非炎性NAFLD患者中HCC的发病率较低，约为0.1 - 1.3/1000患者-年。虽然NAFLD相关HCC的发病率低于其他病因如丙型肝炎的HCC，但NAFLD的发病率高于其他肝病。有必要采取紧急措施，提高全球意识并解决代谢风险因素，以减少NAFLD相关HCC的即将到来的负担。新出现的证据表明，免疫监视减少，肠道炎症增加和肠道生态失调是肿瘤发生的潜在关键步骤。在这篇综述中，我们讨论了NAFLD相关HCC的全球流行病学、预测和风险因素，并提出了预防策略来解决这一日益严重的问题。
One quarter of the global population is estimated to have nonalcoholic fatty liver disease (NAFLD). The incidence of nonalcoholic steatohepatitis (NASH) is projected to increase by up to 56% in the next 10 years. NAFLD is already the fastest growing cause of hepatocellular carcinoma (HCC) in the USA, France and the UK. Globally, the prevalence of NAFLD-related HCC is likely to increase concomitantly with the growing obesity epidemic. The estimated annual incidence of HCC ranges from 0.5% to 2.6% among patients with NASH cirrhosis. The incidence of HCC among patients with non-cirrhotic NAFLD is lower, approximately 0.1 to 1.3 per 1,000 patient-years. Although the incidence of NAFLD-related HCC is lower than that of HCC of other aetiologies such as hepatitis C, more people have NAFLD than other liver diseases. Urgent measures that increase global awareness and tackle the metabolic risk factors are necessary to reduce the impending burden of NAFLD-related HCC. Emerging evidence indicates that reduced immune surveillance, increased gut inflammation and gut dysbiosis are potential key steps in tumorigenesis. In this Review, we discuss the global epidemiology, projections and risk factors for NAFLD-related HCC, and propose preventive strategies to tackle this growing problem.
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