Effects of alcohol consumption on multiple hepatocarcinogenesis in patients with fatty liver disease

Abstract

The number of patients with fatty liver disease (FLD) is increasing globally. Ethanol consumption in FLD is known to be associated with an increased risk of hepatocellular carcinoma (HCC), but the effects of alcohol consumption on the occurrence of multiple HCCs remain unclear. We explored the relationship between the daily ethanol intake and the HCC number. Methods: This single center retrospective study enrolled 114 patients without viral or immune hepatitis undergoing first line HCC treatment who had been diagnosed with FLD by abdominal ultrasonography or a liver biopsy at the same time as or before HCC detection. We categorized patients into four groups according to the daily alcohol consumption (<20 g: non alcoholic fatty liver disease, n=45; 20-39 g: low intermediate ethanol intake with FLD, n=13; 40-69 g: high intermediate ethanol intake with FLD, n=31; ≥70 g: alcoholic fatty liver disease, n=25). The relationship between the daily ethanol consumption and the number of HCCs (single or multiple) was examined. Results: The risk of multiple HCCs was significantly higher in the high intermediate ethanol intake with FLD (HR 2.89, 95% CI 1.04-8.02, P=0.042) and alcoholic fatty liver disease (HR 3.14, 95% CI 1.07-9.22, P=0.037) groups than in the others. A multivariate analysis showed that a daily ethanol intake ≥40 g was associated with a significantly increased risk of multiple HCCs (HR 2.82, 95% CI 1.16-6.88, P=0.023). Conclusions: Our findings suggest that a high daily ethanol intake might lead to multiple hepatocarcinogenesis in patients with FLD.

MAFLD: Renovation of clinical practice and disease awareness of fatty liver

“…Even mild-to-moderate alcohol intake has been reported to worsen hepatic fibrosis and increase mortality. 4,[29][30][31][32][33] Recently, phosphatidylethanol, a biological marker for alcohol consumption, has been reported to be useful in predicting advanced fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) who have moderate alcohol consumption. 34 Thus, it is also important to assess fatty liver independent of alcohol intake.…”

Therapeutic Potential of Mitotic Kinases’ Inhibitors in Cancers of the Gastrointestinal System

“…Usually, chronic liver diseases along with cirrhosis caused by infections from hepatitis B and C are associated with hepatocellular carcinomas (HCC) that drive Liver cancers [42]. Long-term liver diseases include the major risk factors for HCC, which is considered the primary liver cancer [44] along with the accumulation of fat in the liver and higher alcohol consumption [45]. The liver function blood tests, imaging tests, and liver biopsies are the standard procedures for the diagnosis of liver cancer [46].…”

Risk Factors, Pathogenesis, and Strategies for Hepatocellular Carcinoma Prevention: Emphasis on Secondary Prevention and Its Translational Challenges

“…Alcohol use at least four times per week annually along with obesity (BMI > 30) increases the incidence of HCC [61]. Kimura et al found that mild alcohol use (<20 g/day) in patients with NASH and advanced fibrosis was associated with a significant increase in the risk of HCC [62], while Ochiai et al showed that ethanol intake ≥ 40 g was associated with a significant increase in multinodular HCCs [63].…”