首页|Hepatocellular Carcinoma in Non-alcoholic Fatty Liver Disease: Current Progresses and Challenges
Hepatocellular Carcinoma in Non-alcoholic Fatty Liver Disease: Current Progresses and Challenges
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The rising global prevalence of metabolic diseases has in-creased the prevalence of non-alcoholic fatty liver disease (NAFLD), leading to an increase in cases of NAFLD-related hepatocellular carcinoma (HCC). To provide an updated liter-ature review detailing epidemiology, risk factors, pathogenic pathways, and treatment strategies linked to NAFLD-related HCC, we conducted a literature search on PubMed from its inception to December 31, 2021. About 25％ of the glob-al population suffers from NAFLD. The annual incidence of HCC among NAFLD patients is approximately 1.8 per 1,000 person-years. Older age, male sex, metabolic comorbidi-ties, unhealthy lifestyle habits (such as smoking and alcohol consumption), physical inactivity, genetic susceptibility, liver fibrosis, and degree of cirrhosis in NAFLD patients are impor-tant risk factors for NAFLD-related HCC. Therefore, low-calo-rie diet, moderate-intensity exercise, treatment of metabolic comorbidities, and cessation of smoking and alcohol are the main measures to prevent NAFLD-related HCC. In addition, all patients with advanced NAFLD-related fibrosis or cirrho-sis should be screened for HCC. Immune suppression disor-ders and changes in the liver microenvironment may be the main pathogenesis of NAFLD-related HCC. Hepatic resection, liver transplantation, ablation, transarterial chemoemboliza-tion, radiotherapy, targeted drugs, and immune checkpoint inhibitors are used to treat NAFLD-related HCC. Lenvatinib treatment may lead to better overall survival, while immune checkpoint inhibitors may lead to worse overall survival. Giv-en the specific risk factors for NAFLD-related HCC, primary prevention is key. Moreover, the same treatment may dif- fer substantially in efficacy against NAFLD-related HCC than against HCC of other etiologies.
Hepatobiliary Surgery Department,Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center,Guangxi Medical University Cancer Hospital,Nanning,Guangxi,China
Hepatic Surgery Center,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei,China
Key Laboratory of Early Prevention andTreatment for Regional High Frequency Tumor(Guangxi Medical University),Ministry of Education,Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor,Nanning,Guangxi,China
Specific Research project of Guangxi for Research Bases and Talents广西自然科学基金Bagui Scholars Programs of Guangxi Zhuang Autonomous Region国家自然科学基金Guangxi Undergraduate Training Program for Innovation and EntrepreneurshipGuangxi Undergraduate Training Program for Innovation and Entrepreneurship
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