NAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
Institute of Hepatology, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
Chin Med J (Engl). 2021 Dec 1;134(24):2911-2921. doi: 10.1097/CM9.0000000000001888.
The emergence of non-alcoholic fatty liver disease (NAFLD) as the leading chronic liver disease worldwide raises some concerns. In particular, NAFLD is closely tied to sedentary lifestyle habits and associated with other metabolic diseases, such as obesity and diabetes. At the end of the disease spectrum, non-alcoholic steatohepatitis (NASH) may progress to cirrhosis and hepatocellular carcinoma (HCC), representing a serious health problem to modern society. Recently, an increasing number of HCC cases originating from this progressive disease spectrum have been identified, with different levels of severity and complications. Updating the current guidelines by placing a bigger focus on this emerging cause and highlighting some of its unique features is necessary. Since, the drivers of the disease are complex and multifactorial, in order to improve future outcomes, having a better understanding of NASH progression into HCC may be helpful. The risks that can promote disease progression and currently available management strategies employed to monitor and treat NASH-related HCC make up the bulk of this review.
非酒精性脂肪性肝病 (NAFLD) 的出现成为全球主要的慢性肝病,引起了一些关注。特别是,NAFLD 与久坐的生活习惯密切相关,并与其他代谢性疾病如肥胖症和糖尿病有关。在疾病谱的末端,非酒精性脂肪性肝炎 (NASH) 可能进展为肝硬化和肝细胞癌 (HCC),这对现代社会构成了严重的健康问题。最近,越来越多的源自这种进展性疾病谱的 HCC 病例被识别出来,其严重程度和并发症程度不同。通过更加关注这一新兴病因,并强调其一些独特特征,对当前指南进行更新是必要的。由于疾病的驱动因素复杂且多因素,为了改善未来的结果,更好地了解 NASH 进展为 HCC 可能会有所帮助。促进疾病进展的风险因素以及目前用于监测和治疗与 NASH 相关 HCC 的管理策略构成了本综述的主要内容。