Bader Husam, Yamin Saif, Alshahwan Hamzeh, Farraj Husam, Maghnam Joud, Abu Omar Yazan
Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
School of Medicine, University of Jordan, Amman 11942, Jordan.
J Clin Med. 2024 May 27;13(11):3132. doi: 10.3390/jcm13113132.
This study systematically reviewed the association between metabolic-dysfunction-associated steatotic liver disease (MASLD) and the development of hepatic cancer. Previous research has highlighted MASLD as a predisposing condition. To collect recent global data on the relationship between MASLD and hepatic cancer. A systematic review was conducted, which included an analysis of studies on the relationship between MASLD and the incidence of hepatic cancers, focusing on the role of fibrosis and MASLD severity as predictors of cancer risk. Following standard methodological frameworks for the assessment of longitudinal studies, the review gathered information on fibrosis scores, hepatocellular carcinoma (HCC) incidence, and other types of hepatic neoplasms. A total of 522 studies were initially identified, of which 6 studies were appropriate for the review. They collectively revealed that the stage of fibrosis in MASLD is a significant independent predictor of mortality and liver-related events, with higher fibrosis stages correlating with greater risk. Longitudinal data showed that increases in FIB-4 scores were linked to a higher risk of developing HCC and cirrhosis. MASLD was also associated with an increased risk of non-hepatic cancers such as colorectal cancer in males and breast cancer in females. The severity of MASLD was found to be a modifiable risk factor for biliary tract cancer (BTC), with the risk further amplified by diabetes. Moreover, lifestyle factors and comorbidities, such as smoking and diabetes, were identified as modifiers of cancer risk in MASLD patients. The systematic review identified the association between MASLD and an elevated risk of hepatic cancer, establishing a clear link between the severity of liver fibrosis and the incidence of HCC and other hepatic neoplasms. This supports the need for screening for hepatic cancer in patients with MASLD, particularly in the presence of advanced fibrosis or other risk-modifying factors.
本研究系统回顾了代谢功能障碍相关脂肪性肝病（MASLD）与肝癌发生之间的关联。先前的研究已强调MASLD是一种易感疾病。为收集关于MASLD与肝癌关系的最新全球数据，进行了一项系统评价，其中包括对MASLD与肝癌发病率关系的研究分析，重点关注纤维化和MASLD严重程度作为癌症风险预测指标的作用。遵循评估纵向研究的标准方法框架，该评价收集了关于纤维化评分、肝细胞癌（HCC）发病率及其他类型肝脏肿瘤的信息。最初共识别出522项研究，其中6项研究适合该评价。这些研究共同表明，MASLD中的纤维化阶段是死亡率和肝脏相关事件的重要独立预测指标，纤维化阶段越高，风险越大。纵向数据显示，FIB-4评分升高与发生HCC和肝硬化的风险增加有关。MASLD还与男性患结直肠癌、女性患乳腺癌等非肝癌的风险增加有关。发现MASLD的严重程度是胆管癌（BTC）的一个可改变的风险因素，糖尿病会进一步放大这种风险。此外，生活方式因素和合并症，如吸烟和糖尿病，被确定为MASLD患者癌症风险的调节因素。该系统评价确定了MASLD与肝癌风险升高之间的关联，明确了肝纤维化严重程度与HCC及其他肝脏肿瘤发病率之间的联系。这支持了对MASLD患者进行肝癌筛查的必要性，尤其是在存在晚期纤维化或其他风险调节因素的情况下。
