Kogiso Tomomi, Tokushige Katsutoshi
Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
Cancers (Basel). 2021 Jan 29;13(3):516. doi: 10.3390/cancers13030516.
Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and can develop into hepatocellular carcinoma (HCC). The incidence of NAFLD-related HCC, which is accompanied by life-threatening complications, is increasing. Advanced fibrosis and lifestyle-related and metabolic comorbidities, especially obesity and diabetes mellitus, are associated with HCC development. However, HCC is also observed in the non-cirrhotic liver. Often, diagnosis is delayed until the tumor is relatively large and the disease is advanced; an effective screening or surveillance method is urgently required. Recently, the NAFLD/nonalcoholic steatohepatitis (NASH) guidelines of Japan were revised to incorporate new strategies and evidence for the management and surveillance of NAFLD/NASH. Fibrosis must be tested for noninvasively, and the risk of carcinogenesis must be stratified. The treatment of lifestyle-related diseases is expected to reduce the incidence of NAFLD and prevent liver carcinogenesis.
非酒精性脂肪性肝病(NAFLD)是代谢综合征的肝脏表现,可发展为肝细胞癌(HCC)。与NAFLD相关的HCC发病率正在上升,且伴有危及生命的并发症。肝纤维化进展以及与生活方式相关的代谢合并症,尤其是肥胖和糖尿病,都与HCC的发生有关。然而,在非肝硬化肝脏中也可观察到HCC。通常,诊断会延迟到肿瘤相对较大且疾病进展时;因此迫切需要一种有效的筛查或监测方法。最近,日本的NAFLD/非酒精性脂肪性肝炎(NASH)指南进行了修订,纳入了NAFLD/NASH管理和监测的新策略及证据。必须采用非侵入性方法检测肝纤维化,并对致癌风险进行分层。预计治疗与生活方式相关的疾病可降低NAFLD的发病率并预防肝癌发生。