Smith Robert J
Alpert Medical School of Brown University, Ocean State Research Institute, Providence Veterans Administration Medical Center, 830 Chalkstone Avenue, Providence, RI 02908, USA.
Hepatobiliary Surg Nutr. 2013 Apr;2(2):89-96. doi: 10.3978/j.issn.2304-3881.2012.11.02.
Hepatocellular carcinoma is the fifth most common human cancer worldwide, with an overall 5-year survival in the range of 10%. In addition to the very substantial role of chronic viral hepatitis in causing hepatocellular carcinoma, nutritional status and specific nutritional factors appear to influence disease risk. This is apparent in the increased risk associated with non-alcoholic hepatic cirrhosis occurring in the context of obesity, the metabolic syndrome, and type 2 diabetes. Specific nutrients and ingested toxins, including ethanol, aflatoxin, microcystins, iron, and possibly components of red meat, also are associated with increased hepatocellular carcinoma risk. Other dietary components, including omega-3 fatty acids and branched chain amino acids, may have protective effects. Recent data further suggest that several metabolic regulatory drugs, including metformin, pioglitazone, and statins, may have the potential to decrease the risk of hepatocellular carcinoma. The available data on these nutritional and metabolic factors in causing hepatocellular carcinoma are reviewed with the goal of identifying the strength of current knowledge and directions for future investigation.
肝细胞癌是全球第五大常见人类癌症，总体5年生存率在10%左右。除了慢性病毒性肝炎在引发肝细胞癌中起非常重要的作用外，营养状况和特定营养因素似乎也会影响疾病风险。这在肥胖、代谢综合征和2型糖尿病背景下发生的非酒精性肝硬化相关风险增加中表现明显。特定营养素和摄入的毒素，包括乙醇、黄曲霉毒素、微囊藻毒素、铁以及可能的红肉成分，也与肝细胞癌风险增加有关。其他饮食成分，包括ω-3脂肪酸和支链氨基酸，可能具有保护作用。最近的数据进一步表明，几种代谢调节药物，包括二甲双胍、吡格列酮和他汀类药物，可能有降低肝细胞癌风险的潜力。本文综述了关于这些营养和代谢因素导致肝细胞癌的现有数据，目的是确定当前知识的优势以及未来研究的方向。
