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NAFLD and Hepatocellular Carcinoma: How Big a Problem is This Really?

  • Fatty Liver Disease (SA Harrison and J George, Section Editors)
  • Published:
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Abstract

A definite link between non alcoholic fatty liver disease (NAFLD) and hepatocellular carcinoma (HCC) has emerged. Diabetes, older age and the presence of cirrhosis are the key risk factors for HCC in patients with NAFLD. Although the rates of development of HCC are generally lower compared with viral (HCV) aetiology, the absolute burden of NASH-related HCC is higher. Diagnostic delay, older age and the concurrent presence of severe metabolic or vascular disease limits potentially curative treatment, such as liver transplantation. Most worrisome, is the recent evidence that HCC may develop also in non-cirrhotic livers with NAFLD, particularly in the presence of multiple metabolic risk factors. In the coming decades, we expect a change in the burden of the attributable proportion of HCC shifting from viral hepatitis to NASH, as the major risk factor for HCC worldwide.

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Abbreviations

BMI:

Body mass index

CC:

Cryptogenic cirrhosis

FXR:

Farnesoid X receptor

HCV:

Hepatitis C virus

HCC:

Hepatocellular carcinoma

IGF-1:

Insulin-like growth factor 1

LKB1:

Liver kinase B1

MS:

Metabolic syndrome

NAFLD:

Nonalcoholic fatty liver disease

NASH:

Nonalcoholic steatohepatitis

PNPLA3:

Patatin-like phospholipase domain containing 3

SASP:

Senescence-associated secretory phenotype

TAG:

Triacylglycerol

T2DM:

Type 2 diabetes

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Compliance with Ethics Guidelines

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Conflict of Interest

Ester Vanni declares no conflicts of interest.

Lavinia Mezzabotta declares no conflicts of interest.

Elisabetta Bugianesi declares no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the authors.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Medical Sciences, University of Torino, Torino, Italy

    Ester Vanni, Lavinia Mezzabotta & Elisabetta Bugianesi

  2. S.C. Gastroenterologia ed Epatologia, Dipartimento di Scienze Mediche, Università di Torino, Corso Dogliotti 14, I-10126, Torino, Italy

    Ester Vanni, Lavinia Mezzabotta & Elisabetta Bugianesi

Authors
  1. Ester Vanni
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  2. Lavinia Mezzabotta
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  3. Elisabetta Bugianesi
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Correspondence to Elisabetta Bugianesi.

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Vanni, E., Mezzabotta, L. & Bugianesi, E. NAFLD and Hepatocellular Carcinoma: How Big a Problem is This Really?. Curr Hepatology Rep 13, 113–118 (2014). https://doi.org/10.1007/s11901-014-0225-7

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  • DOI: https://doi.org/10.1007/s11901-014-0225-7

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