Non-alcoholic Steatohepatitis (NASH) and Hepatocellular Carcinoma

Cuadrado, Antonio; Orive, Aitor; García-Suárez, Covadonga; Domínguez, Agustín; Fernández-Escalante, José Carlos; Crespo, Javier; Pons‐Romero, F.

doi:10.1381/0960892053576596

Cited by 100 publications

(61 citation statements)

References 22 publications

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“…8,52,57,[93][94][95][96][97][98][99][100][101][102][103][104][105][106][107][108][109] Male patients make up the majority of cases with a mean age at diagnosis of 66.7 (range ¼ 45-82). The patients are typically older at presentation than patients with HCC related to other chronic liver diseases.…”

Section: Case Reports and Case Series Of Nash And Hccmentioning

confidence: 99%

“…Up to 50% of patients have HCC at the time of initial referral, and rarely patients present with HCC in the absence of cirrhosis. 8,93,94,96,101,[105][106][107][108][109] The fact that HCC can arise in the setting of NASH without underlying cirrhosis raises the interesting possibility that carcinogenesis can occur in NAFLD in the absence of advanced liver disease. 108 Three recent case studies of patients with HCC in the setting of NASH support the findings of previous case reports.…”

Section: Case Reports and Case Series Of Nash And Hccmentioning

confidence: 99%

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Nonalcoholic fatty liver disease and hepatocellular carcinoma: A weighty connection

2010

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Hepatocellular carcinoma (HCC) is a common and deadly malignancy that is increasing in incidence in developed countries. The emergence of hepatitis C virus (HCV) accounts for about half of this increase in HCC, although the etiology of HCC in 15%-50% of new HCC cases remains unclear. The most common form of chronic liver disease in developed countries is nonalcoholic fatty liver disease (NAFLD), which encompasses a broad spectrum of histopathology. The prevalence of NAFLD, including the more aggressive nonalcoholic steatohepatitis (NASH), is increasing with the growing epidemics of diabetes and obesity. NASH can progress to cirrhosis and its related complications. Growing evidence suggests that NASH accounts for a large proportion of idiopathic or cryptogenic cirrhosis, which is associated with the typical risk factors for NASH. HCC is a rare, although important complication of NAFLD. Diabetes and obesity have been established as independent risk factors for the development of HCC. New evidence also suggests that hepatic iron deposition increases the risk of HCC in NASH-derived cirrhosis. Multiple case reports and case reviews of HCC in the setting of NASH support the associations of diabetes and obesity with the risk of HCC, as well as suggest age and advanced fibrosis as significant risks. Insulin resistance and its subsequent inflammatory cascade that is associated with the development of NASH appear to play a significant role in the carcinogenesis of HCC. The complications of NASH, including cirrhosis and HCC, are expected to increase with the growing epidemic of diabetes and obesity.

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Section: Case Reports and Case Series Of Nash And Hccmentioning

confidence: 99%

Section: Case Reports and Case Series Of Nash And Hccmentioning

confidence: 99%

Nonalcoholic fatty liver disease and hepatocellular carcinoma: A weighty connection

2010

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“…It has been observed that at the time of diagnosis, advanced fibrosis is already found in 30-40% of NASH patients, and 10-15% already have established cirrhosis. Since NASH may progress to cirrhosis (NASH being responsible for 70% of cryptogenic cirrhosis) [128], HCC development may be a part of the natural history of this disease [129]. A recent study by Chen et al [58], which enrolled 23,820 residents in Taiwan with a 14-year followup, showed that extreme obesity (BMI C 30 kg/m 2 ) was independently associated with a fourfold risk of HCC in anti-HCV-positive subjects and a twofold risk of HCC in those without HBV or HCV after controlling for other metabolic components.…”

Section: Nash and Hccmentioning

confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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“…There is some evidence that HCC may develop as the last step in the natural history of progressive NASH, based on case reports of HCC in patients with NASH-related cirrhosis from various parts of the world, including Southern Europe (Cotrim et al, 2000;Zen et al, 2001;Shimada et al, 2002;Cuadrado et al, 2005). Almost all the HCC cases had obesity and/or type II diabetes, and they were all negative for HBsAg and anti-HCV, with biopsy-based diagnosis of NASH-related cirrhosis.…”

Section: Non-alcoholic Steatohepatitis and Hepatocellular Carcinomamentioning

confidence: 99%

Southern Europe as an example of interaction between various environmental factors: a systematic review of the epidemiologic evidence

et al. 2006

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Hepatitis B virus (HBV), hepatitis C virus (HCV) and alcohol consumption are major causes of hepatocellular carcinoma (HCC) worldwide. We performed a systematic review of epidemiologic studies carried out on HCC aetiology in Southern Europe, an area with an intermediatehigh prevalence of these agents as well as of putative risk factors such as tobacco smoking, diabetes and obesity. To retrieve the articles, we performed a Medline search for titles and abstracts of articles. After the Medline search, we reviewed the papers and reference lists to identify additional articles. A synergism between HCV infection and HBV infection, overt (hepatitis B virus antigen (HbsAg) positivity) or occult (HBsAg negativity with presence of HBV DNA in liver or serum), is suggested by the results of some studies. The pattern of the risk for HCC due to alcohol intake shows a continuous dose-effect curve without a definite threshold, although most studies found that HCC risk increased only for alcohol consumption above 40-60 g of ethanol per day. Some evidence supports a positive interaction of alcohol intake probably with HCV infection and possibly with HBV infection. A few studies found that coffee has a protective effect on HCC risk due to various risk factors. Some data also support a role of tobacco smoking, diabetes and obesity as single agents or preferably cofactors in causing HCC. In countries with a relatively high alcohol consumption and intermediate levels of HCV and HBV infections (1-3% of population infected by each virus), such as Mediterranean countries, the three main risk factors together account for about 85% of the total HCC cases, leaving little space to other known risk factors, such as haemochromatosis, and to new, still unrecognised, factors as independent causes of HCC.

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Non-alcoholic Steatohepatitis (NASH) and Hepatocellular Carcinoma

Cited by 100 publications

References 22 publications

Nonalcoholic fatty liver disease and hepatocellular carcinoma: A weighty connection

Nonalcoholic fatty liver disease and hepatocellular carcinoma: A weighty connection

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Southern Europe as an example of interaction between various environmental factors: a systematic review of the epidemiologic evidence

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