Pocha Christine, Xie Chencheng
Avera McKennnan Hospital and University Medical Center, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA.
Department of Gastroenterology and Hepatology, Thomas Jefferson University, Philadelphia, PA, USA.
Transl Gastroenterol Hepatol. 2019 Oct 9;4:72. doi: 10.21037/tgh.2019.09.01. eCollection 2019.
Hepatocellular cancer (HCC) is a cancer with an overall poor prognosis and an alarming globally rising incidence. While viral etiology of chronic liver disease and HCC is down-trending, alcohol and excess calorie intake have emerged as major culprits. Alcohol related liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD) share similar pathogenetic mechanism of hepatic injury and in promoting development of HCC; yet some genetic and epigenetic features are distinct and may promise clinical utility. Population based intervention are urgently needed to reduce alcohol use and improve metabolic factors such as obesity and diabetes. The goal is to identify at-risk patients, to link these patients to care and to provide effective management of chronic liver disease and HCC. This review focuses on the epidemiology, pathophysiology including genetic and epigenetic altercation as well as clinical aspects of ALD and NAFLD associated HCC.
肝细胞癌（HCC）是一种总体预后较差且全球发病率惊人上升的癌症。虽然慢性肝病和HCC的病毒病因呈下降趋势，但酒精和热量摄入过多已成为主要原因。酒精性肝病（ALD）和非酒精性脂肪性肝病（NAFLD）在肝损伤的发病机制以及促进HCC发展方面具有相似之处；然而，一些遗传和表观遗传特征是不同的，可能具有临床应用价值。迫切需要基于人群的干预措施来减少酒精使用并改善肥胖和糖尿病等代谢因素。目标是识别高危患者，将这些患者与医疗服务联系起来，并提供对慢性肝病和HCC的有效管理。本综述重点关注ALD和NAFLD相关HCC的流行病学、病理生理学（包括遗传和表观遗传改变）以及临床方面。
