期刊
WORLD JOURNAL OF GASTROENTEROLOGY
卷 22, 期 37, 页码 8294-8303出版社
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.3748/wjg.v22.i37.8294
关键词
Fatty liver; Nonalcoholic steatohepatitis; Hepatocellular carcinoma; Liver cirrhosis; Liver cancer
资金
- NCATS NIH HHS [UL1 TR001863] Funding Source: Medline
- NIDDK NIH HHS [P30 DK034989] Funding Source: Medline
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the United States and represents an increasingly important etiology of hepatocellular carcinoma (HCC) with annual cumulative incidence rates ranging from 2% to 12% in cohorts of NAFLD cirrhosis. While the risk of progression of NAFLD to HCC remains higher among patients with fibrosis or cirrhosis, an increasing amount of literature describes NAFLD-HCC as a disease that can occur in the absence of cirrhosis. Efforts to characterize the pathogenesis of NAFLD-HCC have suggested mechanisms that strongly associate with states of hyperinsulinemia and chronic inflammation, cellular mechanisms including adaptive immune responses and hepatic progenitor cell populations, and genetic polymorphisms including mutations of PNPLA3. Current literature describes NAFLD-HCC mostly as a disease of late presentation with lower rates of receipt of curative therapy and worse prognosis. However, a growing body of evidence has reported comparable and potentially more favo-rable disease-free and overall survival rates among patients with NAFLD-HCC after receipt of curative treatment. This review summarizes current evidence of epidemiology, pathophysiology, disease presentation, demand and receipt of curative therapy, post-treatment outcomes, and overall survival of NAFLD-associated HCC.
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