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HCC in Patients with NAFLD/NASH

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NAFLD and NASH

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Abstract

Hepatocellular carcinoma (HCC) associated with NAFLD has been steadily increasing and non-alcoholic steatohepatitis (NASH) is the most rapidly growing risk for liver transplantation in patients with HCC in the last years. In the vast majority of cases, HCC develops in the context of hepatic cirrhosis, but recent data suggest that there is a proportion of patients with NAFLD who are at high risk for HCC in the absence of cirrhosis. Although no study clearly explains the evolution of NAFLD to HCC, researchers suggest that the most likely mechanism involves fatty acid (FA) accumulation in hepatocytes due to predisposing factors, such as MtS, increased oxidative stress, endoplasmic reticulum (ER) stress, mitochondrial dysfunction and chronic endotoxaemia. Genetic and epigenetic changes in pathogenesis and hepatic carcinogenesis potentially serve as potential diagnostic biomarkers and/or therapeutic targets. MicroRNAs (miRNAs) play a key role in the pathogenesis of HCC related to NAFLD by closely regulating lipid metabolism, glucose homeostasis, cell proliferation, apoptosis, and cell migration and differentiation. In other words, there are currently no guidelines for the screening and early detection of NAFLD-related HCC in the absence of cirrhosis. However, there is an increasing number of HCC cases without cirrhosis. Thus, there is a strong interest in identifying biomarkers to detect early detection of HCC risk related to NAFLD progression.

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Authors and Affiliations

  1. Laboratório de Gastroenterologia Clínica e Experimental (LIM-07) do Departamento de Gastroenterologia e Hepatologia do Hospital das Clínicas HCFMUSP da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil

    Jose Tadeu Stefano & Claudia P. Oliveira

  2. Department of Infectious Disease and Institute of Tropical Medicine, University of São Paulo School of Medicine, São Paulo, SP, Brazil

    Fernanda de Mello Malta

  3. Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil

    Priscila Brizola de Campos, Pedro Fernandes Andrade, Flair Jose Carrilho & Claudia P. Oliveira

  4. Disciplina de Gastroenterologia Clínica do Hospital das Clínicas HCFMUSP da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil

    Denise Cerqueira Paranaguá-Vezzozo

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  1. Jose Tadeu Stefano
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  1. UCM Digestive Diseases, Virgen del Rocio University Hospital, Sevilla, Spain

    Manuel Romero-Gomez

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Stefano, J.T. et al. (2020). HCC in Patients with NAFLD/NASH. In: Romero-Gomez, M. (eds) NAFLD and NASH. Springer, Cham. https://doi.org/10.1007/978-3-030-37173-9_11

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