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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Nonalcoholic fatty liver disease and hepatocellular carcinoma: a weighty connection.
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Nonalcoholic fatty liver disease and hepatocellular carcinoma: a weighty connection.

机译：非酒精性脂肪肝疾病和肝细胞癌：重大的联系。

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摘要

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.
机译：肝细胞癌（HCC）是一种常见的致命恶性肿瘤，在发达国家中发病率不断上升。尽管尚不清楚15％-50％的新HCC病例的HCC病因，但丙型肝炎病毒（HCV）的出现约占HCC上升的一半。在发达国家，慢性肝病最常见的形式是非酒精性脂肪肝（NAFLD），其涵盖了广泛的组织病理学。随着糖尿病和肥胖病的流行，NAFLD的流行，包括更具攻击性的非酒精性脂肪性肝炎（NASH），正在增加。 NASH可发展为肝硬化及其相关并发症。越来越多的证据表明，NASH在特发性或隐源性肝硬化中占很大比例，这与NASH的典型危险因素有关。肝癌是一种罕见的NAFLD重要并发症。糖尿病和肥胖已被确定为肝癌发展的独立危险因素。新证据还表明，肝性铁沉积会增加NASH引起的肝硬化发生HCC的风险。在NASH的情况下，多例病例报告和HCC病例回顾支持了糖尿病和肥胖与HCC风险之间的关联，并暗示年龄和晚期纤维化是重大风险。与NASH的发展有关的胰岛素抵抗及其随后的炎症级联似乎在HCC的癌变过程中起着重要作用。随着糖尿病和肥胖病的流行，NASH的并发症（包括肝硬化和HCC）预计会增加。

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