Cholankeril George, Patel Ronak, Khurana Sandeep, Satapathy Sanjaya K
George Cholankeril, Sanjaya K Satapathy, Division of Gastroenterology and Hepatology, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, TN 38104, United States.
World J Hepatol. 2017 Apr 18;9(11):533-543. doi: 10.4254/wjh.v9.i11.533.
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.
随着丙型肝炎病毒的流行率预计下降，由于肥胖症和糖尿病的流行加剧，与非酒精性脂肪性肝炎（NASH）相关的肝细胞癌（HCC）比例预计将呈指数级增长。NASH相关肝硬化患者发生HCC的年发病率尚不清楚，范围在2.6%-12.8%之间。虽然多种新机制与NASH中HCC的发生有关，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，相当一部分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。肝切除和移植是部分NASH相关HCC患者的治愈性治疗选择，但给我们的医疗资源和利用带来了巨大负担。目前，NASH相关HCC是肝癌候选者中增长最快的肝移植适应症。需要加大力度实施有效的筛查和预防策略，特别是在非肝硬化NASH患者中，以减少NASH相关HCC未来造成的影响。
