Guzman Grace, Brunt Elizabeth M, Petrovic Lydia M, Chejfec Gregorio, Layden Thomas J, Cotler Scott J
Department of Pathology, University of Illinois at Chicago, Chicago, IL 60614, USA.
Arch Pathol Lab Med. 2008 Nov;132(11):1761-6. doi: 10.5858/132.11.1761.
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.
To seek evidence that HCC can develop in NAFLD unaccompanied by cirrhosis.
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.
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.
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.
肝细胞癌（HCC）被认为是非酒精性脂肪性肝病（NAFLD）相关肝硬化的一种并发症。糖尿病和代谢综合征也与HCC有关。然而，在没有肝硬化的情况下，NAFLD是否会使患者易患HCC尚不清楚。
寻找证据证明在无肝硬化的NAFLD中可发生HCC。
对2004年至2007年伊利诺伊大学芝加哥分校医学中心的病例进行回顾性病例研究，使用关键词肝细胞癌、肝移植和肝切除术。通过苏木精-伊红染色切片在50例病例中确定并证实了HCC的诊断。通过回顾肝脏组织学、临床病史和实验室数据来确定肝病病因。
3例患者表现为晚期HCC，具有代谢综合征特征，包括体重指数升高。每位患者肝活检均有单纯性脂肪变性，无纤维化或肝硬化。这3例患者均无除NAFLD以外的任何肝病病因证据。
此处报告的病例提示，在无肝硬化的情况下，NAFLD可能使患者易患HCC。需要进一步研究来证实这一潜在的重要观察结果。
