Kwon Oh Sang, Kim Joon Hwan, Kim Ju Hyun
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
Korean J Gastroenterol. 2017 Jun 25;69(6):348-352. doi: 10.4166/kjg.2017.69.6.348.
Non-alcoholic fatty liver disease (NAFLD) may be one of the important causes of cryptogenic hepatocellular carcinoma (HCC). NAFLD-related HCCs (NAFLD-HCCs) have the following clinical features: high body mass index, deranged lipid profiles, diabetes mellitus, hypertension, and metabolic syndrome. Among them, obesity, diabetes mellitus, and high Fe contents in the liver are risk factors of developing HCC in patients with NAFLD. Inflammatory cytokines, adipokines, insulin like growth factor-I, and lipotoxicity are intermingled and may cross react with each other to develop HCC. Because there is no guideline for early detection of HCC in patients with NAFLD, NAFLD-HCCs tend to be greater in size and in advanced stages when detected compared with hepatitis virus-related HCCs. Therefore, there is an urgent need of a surveillance program for the early detection of HCC. Treatment of NAFLD-HCCs is not different from other causes-related HCCs. However, patients with NAFLD-HCCs have cardiovascular disease and other metabolic problems, which may complicate treatment.
非酒精性脂肪性肝病（NAFLD）可能是隐匿性肝细胞癌（HCC）的重要病因之一。NAFLD相关的HCC（NAFLD-HCC）具有以下临床特征：高体重指数、血脂异常、糖尿病、高血压和代谢综合征。其中，肥胖、糖尿病和肝脏中铁含量高是NAFLD患者发生HCC的危险因素。炎性细胞因子、脂肪因子、胰岛素样生长因子-I和脂毒性相互交织，可能相互交叉反应导致HCC的发生。由于目前尚无NAFLD患者HCC早期检测的指南，与肝炎病毒相关的HCC相比，NAFLD-HCC在被检测到时往往体积更大且处于晚期。因此，迫切需要一个用于HCC早期检测的监测计划。NAFLD-HCC的治疗与其他病因相关的HCC并无不同。然而，NAFLD-HCC患者患有心血管疾病和其他代谢问题，这可能使治疗复杂化。
