Benhammou Jihane N, Lin Jonathan, Hussain Shehnaz K, El-Kabany Mohamed
Pfleger Liver Institute, University of California Los Angeles, Los Angeles, CA 90095, USA.
Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Hepatoma Res. 2020;6. doi: 10.20517/2394-5079.2020.16. Epub 2020 Jun 18.
Worldwide, nonalcoholic fatty liver disease (NAFLD) has reached epidemic proportions and in parallel, hepatocellular carcinoma (HCC) has become one of the fastest growing cancers. Epidemiological studies have not only shed light on the prevalence and incidence of the disease but have also unmasked important environmental risk factors, including the role of diabetes and dyslipidemia in disease pathogenesis. Genetic association studies have identified single nucleotide polymorphisms implicated in NAFLD-HCC, many of which are part of lipid metabolism pathways. Through these clinical studies and subsequently, translational and basic research, the role of statins as a chemoprotective agent has also emerged with ongoing clinical trials assessing their utility in HCC prevention and treatment. In this review, we summarize the recent epidemiological studies describing the burden of NAFLD-HCC in different patient populations and countries. We discuss the genetic and environmental risk factors for NAFLD-HCC and highlight the chemoprotective role of statins and aspirin. We also summarize what is known about NAFLD-HCC in the cirrhosis and non-cirrhosis populations and briefly address the role of surveillance in NAFLD-HCC patients.
在全球范围内，非酒精性脂肪性肝病（NAFLD）已达到流行程度，与此同时，肝细胞癌（HCC）已成为增长最快的癌症之一。流行病学研究不仅揭示了该疾病的患病率和发病率，还揭示了重要的环境危险因素，包括糖尿病和血脂异常在疾病发病机制中的作用。基因关联研究已经确定了与NAFLD-HCC相关的单核苷酸多态性，其中许多是脂质代谢途径的一部分。通过这些临床研究以及随后的转化研究和基础研究，他汀类药物作为一种化学预防剂的作用也已显现，目前正在进行临床试验以评估其在HCC预防和治疗中的效用。在这篇综述中，我们总结了最近描述不同患者群体和国家中NAFLD-HCC负担的流行病学研究。我们讨论了NAFLD-HCC的遗传和环境危险因素，并强调了他汀类药物和阿司匹林的化学保护作用。我们还总结了在肝硬化和非肝硬化人群中关于NAFLD-HCC的已知情况，并简要讨论了监测在NAFLD-HCC患者中的作用。
