Hepatocellular carcinoma in non-alcoholic steatohepatitis: Current knowledge and implications for management.
Hepatocellular carcinoma in non-alcoholic steatohepatitis: Current knowledge and implications for management.
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DOI：
10.4254/wjh.v9.i11.533
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发表时间：
2017-04-18
影响因子：
2.4
通讯作者：
Satapathy SK
中科院分区：
文献类型：
--
作者：
Cholankeril G;Patel R;Khurana S;Satapathy SK
随着丙型肝炎病毒的患病率预计将下降，由于肥胖和糖尿病的流行日益增加，与非酒精性脂肪性肝炎（NASH）相关的肝细胞癌（HCC）的比例预计将呈指数级增加。NASH相关肝硬化患者发生HCC的年发病率尚不清楚，范围为2.6%-12.8%。虽然NASH中HCC的发展涉及多种新机制，但需要进一步的前瞻性长期研究来验证这些发现。最近的证据表明，非酒精性脂肪性肝病和NASH患者在没有肝硬化的情况下进展为HCC的比例很大。肝切除术和肝移植是选择性NASH相关HCC患者的治愈性治疗选择，但对我们的医疗资源和利用造成了重大负担。目前，NASH相关的HCC是HCC候选人中肝移植增长最快的适应症。需要加大力度实施有效的筛查和预防策略，特别是在非酒精性NASH患者中，以减少NASH相关HCC对未来的影响。
With the prevalence of hepatitis C virus expected to decline, the proportion of hepatocellular carcinoma (HCC) related to non-alcoholic steatohepatitis (NASH) is anticipated to increase exponentially due to the growing epidemic of obesity and diabetes. The annual incidence rate of developing HCC in patients with NASH-related cirrhosis is not clearly understood with rates ranging from 2.6%-12.8%. While multiple new mechanisms have been implicated in the development of HCC in NASH; further prospective long-term studies are needed to validate these findings. Recent evidence has shown a significant proportion of patients with non-alcoholic fatty liver disease and NASH progress to HCC in the absence of cirrhosis. Liver resection and transplantation represent curative therapeutic options in select NASH-related HCC patients but have placed a significant burden to our healthcare resources and utilization. Currently NASH-related HCC is the fastest growing indication for liver transplant in HCC candidates. Increased efforts to implement effective screening and preventative strategies, particularly in non-cirrhotic NASH patients, are needed to reduce the future impact imposed by NASH-related HCC.