Research advances on metabolic dysfunction-associated fatty liver disease-related hepatocellular carcinoma
Metabolic dysfunction-associated fatty liver disease(MAFLD),formerly named non-al-coholic fatty liver disease(NAFLD),encompasses a spectrum of conditions from simple steatosis to non-al-coholic steatohepatitis(NASH).With the rapid increase in MAFLD prevalence,the incidence of MAFLD-related hepatocellular carcinoma(MAFLD-HCC)is also rising globally.MAFLD has become a leading cause of HCC in many countries.Compared with HCC caused by other etiologies,patients with MAFLD-HCC are often older,diagnosed at later stages,and have poorer prognosis.Moreover,MAFLD-HCC can occur in non-cirrhotic liver.It is predicted that the number of incidental MAFLD-HCC cases will increase by 80％-120％in China,France,and the United States in the next decade.Diabetes and obesity are major risk factors for developing HCC in MAFLD.In addition to demographic factors such as age and sex,PNPLA3 polymorphisms are associated with increased risk of MAFLD-HCC.Latest evidence suggests that gut dysbiosis,chronic inflammation,and impaired immune surveillance play important roles in MAFLD-HCC development.Regular HCC surveillance is recommended for MAFLD patients with advanced fibrosis or cirrhosis.Lifestyle interventions,anti-diabetic medications,statins,and aspirin may help reduce MAFLD-HCC risk,but further clinical trials are needed.This article reviews the latest research progress on the epidemiology,pathogenesis,risk factors,diagnosis,and prevention of MAFLD-HCC,aiming to provide new insights into the management of this disease.
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