MASLD and the Development of HCC: Pathogenesis and Therapeutic Challenges.
MASLD and the Development of HCC: Pathogenesis and Therapeutic Challenges.
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DOI：
10.3390/cancers16020259
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发表时间：
2024-01-06
期刊：
影响因子：
5.2
通讯作者：
Khakoo, Salim I.
中科院分区：
文献类型：
--
作者：
Phoolchund, Anju G. S.;Khakoo, Salim I.
关键词：
代谢功能障碍相关的脂肪性肝病（以前称为非酒精性脂肪性肝病）是一系列肝脏疾病的术语，其中多余的脂肪在肝脏中积聚。这最终可能导致肝脏炎症，慢性肝病，在某些情况下，还可能导致肝癌（肝细胞癌）。这种情况在世界范围内正在增加，患者最有可能超重或肥胖或患有2型糖尿病。肝细胞癌在不同阶段的患者中可见，研究正在进行中，以确定为什么有些患者似乎在肝病的早期阶段比其他人发展癌症，以及如何最好地治疗他们，因为患者的反应似乎有所不同，这取决于最初引起肝脏炎症的原因。在这里，我们总结了迄今为止的研究，并讨论了所观察到的潜在原理。代谢功能障碍相关性脂肪性肝病（MASLD，以前称为非酒精性脂肪性肝病（NAFLD））是慢性肝病和肝细胞癌（HCC）的快速增加的原因，反映了西方世界肥胖和代谢综合征的发病率增加。与慢性肝病的其他原因相比，MASLD-HCC可以在纤维化的早期发展，这对如何对患者进行风险分层以建立有效的筛查计划提出了挑战。MASLD-HCC的治疗决策也因医学合并症和后期疾病表现而复杂化。对治疗的反应，特别是免疫检查点抑制剂，可能因疾病的病因而异，并且在未来，患者分层将是优化治疗途径的关键。
Metabolic-dysfunction-associated steatotic liver disease (previously known as non-alcoholic fatty liver disease) is a term for a range of liver conditions in which excess fat builds up in the liver. This can eventually lead to liver inflammation, chronic liver disease and, in some cases, a form of liver cancer (hepatocellular carcinoma). This condition is increasing worldwide, with patients most at risk being overweight or obese or having type 2 diabetes. Hepatocellular carcinoma is seen in patients with this condition at different stages, and research is ongoing to identify why some patients appear to develop cancer at an earlier stage of liver disease than others, and how to best treat them, as there appear to be variations in how well patients respond depending on what caused the liver inflammation initially. Here, we summarise the research to date and discuss the potential rationale for what has been observed. Metabolic-dysfunction-associated steatotic liver disease (MASLD, previously known as non-alcoholic fatty liver disease (NAFLD)) represents a rapidly increasing cause of chronic liver disease and hepatocellular carcinoma (HCC), mirroring increasing rates of obesity and metabolic syndrome in the Western world. MASLD-HCC can develop at an earlier stage of fibrosis compared to other causes of chronic liver disease, presenting challenges in how to risk-stratify patients to set up effective screening programmes. Therapeutic decision making for MASLD-HCC is also complicated by medical comorbidities and disease presentation at a later stage. The response to treatment, particularly immune checkpoint inhibitors, may vary by the aetiology of the disease, and, in the future, patient stratification will be key to optimizing the therapeutic pathways.
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