Τίτλος:
Clinical heterogeneity in patients with non-alcoholic fatty liver disease-associated hepatocellular carcinoma
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Introduction: The indisputable increase in nonalcoholic Fatty Liver Disease (NAFLD) prevalence (25% of population) has consequently led to an increase in Hepatocellular Carcinoma (HCC) and liver-related mortality worldwide. The characteristics of patients with HCC, secondary to NAFLD, are older age, large tumors due to late diagnosis, often without cirrhosis and high prevalence of the metabolic syndrome components, leading to an increased mortality rate. Although the mechanisms of disease remain partially obscure, insulin resistance, oxidative stress, apoptosis, iron overload, and excessive local and systemic inflammation are identified as culprits for hepatocarcinogenesis in the presence of NAFLD. Area covered: In this review, the authors report that there are no uniform guidelines for surveillance and early diagnosis in this patient group. Barcelona Clinic Liver Cancer staging is generally applicable to HCC due to NAFLD and management depends on liver function, tumor characteristics, and cardiovascular comorbidity. Evidence suggests that HCC due to NAFLD can be associated with worse survival due to late diagnosis. Expert opinion: The need for effective early diagnosis and management of NAFLD is urgent, considering the galloping incidence of the obesity and the fact that liver cirrhosis and HCC due to NAFLD will become the first indication for liver transplantation in foreseeable future. © 2020 Informa UK Limited, trading as Taylor & Francis Group.
Συγγραφείς:
Anastasopoulos, N.-A.T.
Lianos, G.D.
Tatsi, V.
Karampa, A.
Goussia, A.
Glantzounis, G.K.
Περιοδικό:
Expert Review of Gastroenterology and Hepatology
Εκδότης:
Taylor and Francis Ltd.
Λέξεις-κλειδιά:
alpha fetoprotein; sorafenib, alcohol consumption; Barcelona Clinic Liver Cancer staging; cancer prognosis; cancer screening; cancer staging; chemoembolization; comorbidity; diabetes mellitus; dyslipidemia; early cancer diagnosis; human; iron homeostasis; liver carcinogenesis; liver cell carcinoma; liver cirrhosis; liver fibrosis; liver resection; liver transplantation; malignant transformation; metabolic syndrome X; nonalcoholic fatty liver; obesity; Review; tumor ablation; tumor recurrence; biological variation; disease exacerbation; early cancer diagnosis; liver cell carcinoma; liver cirrhosis; liver tumor; mortality; nonalcoholic fatty liver; obesity; predictive value; prevalence; risk assessment; risk factor, Biological Variation, Individual; Carcinoma, Hepatocellular; Disease Progression; Early Detection of Cancer; Humans; Liver Cirrhosis; Liver Neoplasms; Neoplasm Staging; Non-alcoholic Fatty Liver Disease; Obesity; Predictive Value of Tests; Prevalence; Risk Assessment; Risk Factors
DOI:
10.1080/17474124.2020.1802244
