Hepatocellular carcinoma in non-alcoholic steatohepatitis:Current knowledge and implications for management

作     者：George Cholankeril Ronak Patel Sandeep Khurana Sanjaya K Satapathy 

作者机构：Division of Gastroenterology and Hepatology Methodist University Hospital Transplant Institute University of Tennessee Health Sciences Center Department of Medicine University of Alabama at Birmingham Montgomery Health Center Division of Gastroenterology Georgia Regents University 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2017年第9卷第11期

页      面：533-543页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100214[医学-肿瘤学] 10[医学] 

主　　题：非酒精的 steatohepatitis 肝硬化 非酒精的脂肪肝疾病 肥胖 Hepatocellular 癌 

摘      要：With the prevalence of hepatitis C virus expected to decline, the proportion of hepatocellular carcinoma(HCC) related to non-alcoholic steatohepatitis(NASH) is anticipated to increase exponentially due to the growing epidemic of obesity and diabetes. The annual incidence rate of developing HCC in patients with NASH-related cirrhosis is not clearly understood with rates ranging from 2.6%-12.8%. While multiple new mechanisms have been implicated in the development of HCC in NASH; further prospective long-term studies are needed to validate these findings. Recent evidence has shown a significant proportion of patients with non-alcoholic fatty liver disease and NASH progress to HCC in the absence of cirrhosis. Liver resection and transplantation represent curative therapeutic options in select NASHrelated HCC patients but have placed a significant burden to our healthcare resources and utilization. Currently NASH-related HCC is the fastest growing indication for liver transplant in HCC candidates. Increased efforts to implement effective screening and preventative strategies, particularly in non-cirrhotic NASH patients, are needed to reduce the future impact imposed by NASH-related HCC.