Does Nonalcoholic Fatty Liver Disease Predispose Patients to Hepatocellular Carcinoma in the Absence of Cirrhosis?
Does Nonalcoholic Fatty Liver Disease Predispose Patients to Hepatocellular Carcinoma in the Absence of Cirrhosis?
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DOI：
10.1043/1543-2165-132.11.1761
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发表时间：
2008-11-01
影响因子：
4.6
通讯作者：
Cotler, Scott J.
中科院分区：
文献类型：
--
作者：
Guzman, Grace;Brunt, Elizabeth M.;Cotler, Scott J.
背景。-肝细胞癌（HCC）被认为是与非酒精性脂肪性肝病（NAFLD）相关的肝硬化的并发症。糖尿病和代谢综合征也与HCC相关。然而，目前尚不清楚NAFLD是否使患者在没有肿瘤的情况下易患HCC。寻找证据表明，肝细胞癌可以在NAFLD中发展，而不伴有腹水。回顾性病例研究的病例从2004年至2007年在伊利诺伊大学芝加哥医学中心，使用关键词肝细胞癌，肝移植，肝切除。其中50例经苏木精-伊红染色切片确诊。通过回顾肝脏组织学、临床病史和实验室数据来确定肝脏疾病的原因。3例患者表现为晚期HCC，伴有代谢综合征，包括体重指数升高。每例患者的肝活检均显示轻度脂肪变性，无纤维化或肝硬化。3例患者中没有任何证据表明除NAFLD外还有其他肝病原因。这里介绍的病例表明，在没有肝硬化的情况下，NAFLD可能使患者易患肝癌。需要进一步的研究来证实这一潜在的重要观察结果。
Context.-Hepatocellular carcinoma (HCC) is recognized as a complication of cirrhosis related to nonalcoholic fatty liver disease (NAFLD). Diabetes and the metabolic syndrome are also associated with HCC. However, it is not clear whether NAFLD predisposes patients to HCC in the absence of cirrhosis.Objective.-To seek evidence that HCC can develop in NAFLD unaccompanied by cirrhosis.Design.-Retrospective case study was performed on cases from 2004 to 2007 at the University of Illinois at Chicago Medical Center, using the key words hepatocellular carcinoma, liver explant, and liver resection. The diagnosis of HCC was identified and confirmed by hematoxylin-eosin-stained slides in 50 cases. Cause of liver disease was determined by review of liver histology, clinical history, and laboratory data.Results.-Three patients presented with advanced HCC with features of metabolic syndrome, including an elevated body mass index. Each patient had bland steatosis on liver biopsy, without fibrosis or cirrhosis. None of the 3 patients had evidence of any cause for liver disease other than NAFLD.Conclusions.-The cases presented here suggest that NAFLD may predispose patients to HCC in the absence of cirrhosis. Further studies are needed to confirm this potentially important observation.