非酒精性脂肪性肝病与肝细胞癌
Nonalcoholic fatty liver disease and hepatocellular carcinoma.
作者信息
Klein Stephanie, Dufour Jean-François
机构信息
Department of Clinical Research, Hepatology, University of Bern, Bern, Switzerland.
University Clinic for Visceral Surgery & Medicine, Inselspital Bern, Bern, Switzerland.
出版信息
Hepat Oncol. 2017 Jul;4(3):83-98. doi: 10.2217/hep-2017-0013. Epub 2017 Oct 30.
Abstract
Hepatocellular carcinoma (HCC) in patients with nonalcoholic fatty liver disease is becoming more common globally. The incidence of HCC due to nonalcoholic steatohepatitis in comparison to other etiologies is increasing. This is due to the pandemic of obesity and diabetes mellitus, two important risk factors for HCC. HCC arising in this context occurs in about 40% of the cases in a liver which is not yet cirrhotic. This has implications regarding the population which should be enrolled in an HCC surveillance program and regarding the treatment options. Surgery is more frequently contemplated in patients with HCC and no cirrhosis. However, patients with nonalcoholic steatohepatitis-induced HCC have frequent co-morbidities which have to be taken into account when developing a management strategy. Interestingly, these patients are frequently on medications which have been suggested to decrease the risk to develop HCC.
摘要
非酒精性脂肪性肝病患者的肝细胞癌在全球范围内正变得越来越普遍。与其他病因相比，非酒精性脂肪性肝炎导致的肝细胞癌发病率正在上升。这归因于肥胖症和糖尿病的流行，这两种疾病是肝细胞癌的两个重要风险因素。在这种情况下发生的肝细胞癌约40%出现在尚未发生肝硬化的肝脏中。这对应纳入肝细胞癌监测计划的人群以及治疗选择都有影响。对于没有肝硬化的肝细胞癌患者，手术治疗的考虑更为频繁。然而，非酒精性脂肪性肝炎所致肝细胞癌患者常有合并症，在制定管理策略时必须予以考虑。有趣的是，这些患者经常服用一些被认为可降低发生肝细胞癌风险的药物。
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