Hepatocellular Carcinoma in Non-Alcoholic Fatty Liver Disease: From Epidemiology to Diagnostic Approach

Ivica Grgurevic; Tonci Bozin; Mislav Mikus; Michal Kukla; James O’Beirne

doi:10.3390/cancers13225844

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Hepatocellular Carcinoma in Non-Alcoholic Fatty Liver Disease: From Epidemiology to Diagnostic Approach

Journal article

Open access

Peer reviewed

Hepatocellular Carcinoma in Non-Alcoholic Fatty Liver Disease: From Epidemiology to Diagnostic Approach

Ivica Grgurevic, Tonci Bozin, Mislav Mikus, Michal Kukla and James O’Beirne

Cancers, Vol.13(22), pp.1-20

2021

DOI: https://doi.org/10.3390/cancers13225844

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Abstract

hepatocellular carcinoma

non-alcoholic fatty liver disease

metabolic syndrome

diabetes mellitus

screening programs

biomarkers

ultrasound Cancers 2021, 13, 5844 https

Non-alcoholic fatty liver disease (NAFLD) is becoming the leading cause of liver morbidity worldwide and, as such, represents the pathogenic background for the increasing incidence of hepatocellular carcinoma (HCC). The annual incidence of NAFLD-related HCC is expected to increase by 45–130% by 2030. Diabetes mellitus is the most important risk factor for HCC development in NAFLD, with the risk further increased when associated with other metabolic traits, such as obesity, arterial hypertension and dyslipidemia. The highest risk of HCC exists in patients with advanced fibrosis or cirrhosis, although 20–50% of HCC cases arise in NAFLD patients with an absence of cirrhosis. This calls for further investigation of the pathogenic mechanisms that are involved in hepatocarcinogenesis, including genetics, metabolomics, the influence of the gut microbiota and immunological responses. Early identification of patients with or at risk of NAFLD is of utmost importance to improve outcomes. As NAFLD is highly prevalent in the community, the identification of cases should rely upon simple demographic and clinical characteristics. Once identified, these patients should then be evaluated for the presence of advanced fibrosis or cirrhosis and subsequently enter HCC surveillance programs if appropriate. A significant problem is the early recognition of non-cirrhotic NAFLD patients who will develop HCC, where new biomarkers and scores are potential solutions to tackle this issue.

Details

Title: Hepatocellular Carcinoma in Non-Alcoholic Fatty Liver Disease: From Epidemiology to Diagnostic Approach
Authors: Ivica Grgurevic (Author) - University of Zagreb
Tonci Bozin (Author) - University Hospital Dubrava
Mislav Mikus (Author) - University Hospital Centre Zagreb
Michal Kukla (Author) - Jagiellonian University
James O’Beirne (Author) - University of the Sunshine Coast
Publication details: Cancers, Vol.13(22), pp.1-20
Publisher: MDPI AG
Date published: 2021
DOI: 10.3390/cancers13225844
ISSN: 2072-6694
Copyright note: Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Organisation Unit: University of the Sunshine Coast, Queensland; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99585407702621
Output Type: Journal article

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