Norero Blanca, Dufour Jean-François
Hepatology, Hospital Sótero del Rio, marcoleta 367, Santiago 8330150, Chile.
Gastroenterology, RED UC Christus, Santiago, Chile.
Ther Adv Endocrinol Metab. 2023 Mar 28;14:20420188231160389. doi: 10.1177/20420188231160389. eCollection 2023.
Over the last decade, metabolic-associated fatty liver disease (MAFLD) has become an important public health issue worldwide. In many countries, MAFLD has become the most common cause of chronic liver disease. On the contrary, hepatocellular carcinoma (HCC) mortality is rising. Liver tumors have become the third cause of cancer mortality worldwide. HCC is the most frequent liver tumor. While the burden of HCC related to viral hepatitis is declining, the prevalence of MAFLD-related HCC is rising rapidly. Classical screening criteria for HCC consider cirrhotic, advanced fibrosis, and viral hepatitis patients. Metabolic syndrome with liver involvement or MAFLD is associated with a higher risk of HCC development, even in the absence of cirrhosis. The question about the cost effectiveness of surveillance for HCC in MAFLD is yet not fully answered. There are no guidelines that address the question of when to start or how to define the population who can benefit of surveillance for HCC in MAFLD patients. This review aims to revise the evidence of HCC development in MAFLD. It hopes to be a step closer to defining screening criteria for HCC in MAFLD.
在过去十年中，代谢相关脂肪性肝病（MAFLD）已成为全球重要的公共卫生问题。在许多国家，MAFLD已成为慢性肝病的最常见病因。相反，肝细胞癌（HCC）的死亡率正在上升。肝脏肿瘤已成为全球癌症死亡的第三大原因。HCC是最常见的肝脏肿瘤。虽然与病毒性肝炎相关的HCC负担正在下降，但MAFLD相关HCC的患病率正在迅速上升。HCC的经典筛查标准适用于肝硬化、晚期纤维化和病毒性肝炎患者。即使在没有肝硬化的情况下，伴有肝脏受累的代谢综合征或MAFLD也与HCC发生风险较高相关。关于MAFLD中HCC监测的成本效益问题尚未得到充分解答。目前尚无指南涉及何时开始或如何界定能从MAFLD患者HCC监测中获益的人群这一问题。本综述旨在修订MAFLD中HCC发生的证据。希望朝着界定MAFLD中HCC的筛查标准更近一步。
