Hepatocellular carcinoma in patients with non-alcoholic steatohepatitis – epidemiology, risk factors, clinical implications and treatment

Straś, Wojciech; Małkowski, Piotr; Tronina, Olga

doi:10.5114/ceh.2020.99506

Cited by 9 publications

(9 citation statements)

References 64 publications

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“…The percentage of liver transplantations performed to treat HCC caused by non-alcoholic steatohepatitis (NASH), often related to metabolic syndrome, has been increasing [ 54 – 56 ]. The risk of occurrence of HCC in patients with obesity and diabetes is 5 times higher than in patients without these disorders [ 57 ].…”

Section: Risk Factors Before Proceduresmentioning

confidence: 99%

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

et al. 2022

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Liver transplantation (LTx) is the best treatment for patients with early-stage hepatocellular carcinoma (HCC). The Milan criteria positively influenced results of liver transplantation and were adopted by the majority of cancer centers, becoming the criterion standard treatment for early-stage HCC. Despite the use of restrictive criteria, recurrence is still high, affecting between 8% and 20% of cases, and is a significant predictor of survival after LTx. The diagnosis of both micro-and macro-invasion of vessels, which are significant factors in determining the frequency of recurrence and overall survival, significantly decreases the success of transplantation, causing an increase in mortality of 50% in comparison to recipients with no vascular invasion. The risk of recurrence depends on several factors, which are discussed in this review. The authors also discuss the clinical presentation and treatment methods of recurrence and its prognosis. In addition, the role of different models developed to identify groups of patients with high versus low risk of recurrence is discussed, enabling the planning of recommendations and screening protocols after transplantation to help early diagnosis and guide effective treatment. In the era of an increasing numbers of liver transplants due to HCC, the need to create robust screening tools is urgent.

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Section: Risk Factors Before Proceduresmentioning

confidence: 99%

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

et al. 2022

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“…This disease comprises different conditions, ranging from uncomplicated steatosis to its severe complication non-alcoholic steatohepatitis (NASH) [ 1 ], a chronic liver disease which, besides the presence of hepatocellular lipids, presents inflammation and injury of the hepatic parenchyma. NAFLD is a quite common condition, since it affects one-fourth of the world population [ 2 ], and it has been estimated that the progression from NAFLD to NASH occurs in nearly one-third of NAFLD patients [ 3 ], although some studies reported that this transition is much more frequent [ 1 ]. It is well known that the progression from NAFLD to NASH is influenced by several factors, including health conditions, such as diabetes and obesity, as well as genetic and environmental factors [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…It has been extensively demonstrated that NASH is a fundamental factor in the etiology of liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC), the latter being the most common form of liver cancer [ 1 , 2 , 3 ]. HCC, which can develop in NASH patients either because of or in the absence of cirrhosis [ 5 ], remains a global health challenge, due to its growing incidence and limited therapeutic options.…”

Section: Introductionmentioning

confidence: 99%

The Role of Oxidative Stress in NAFLD–NASH–HCC Transition—Focus on NADPH Oxidases

2021

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A peculiar role for oxidative stress in non-alcoholic fatty liver disease (NAFLD) and its transition to the inflammatory complication non-alcoholic steatohepatitis (NASH), as well as in its threatening evolution to hepatocellular carcinoma (HCC), is supported by numerous experimental and clinical studies. NADPH oxidases (NOXs) are enzymes producing reactive oxygen species (ROS), whose abundance in liver cells is closely related to inflammation and immune responses. Here, we reviewed recent findings regarding this topic, focusing on the role of NOXs in the different stages of fatty liver disease and describing the current knowledge about their mechanisms of action. We conclude that, although there is a consensus that NOX-produced ROS are toxic in non-neoplastic conditions due to their role in the inflammatory vicious cycle sustaining the transition of NAFLD to NASH, their effect is controversial in the neoplastic transition towards HCC. In this regard, there are indications of a differential effect of NOX isoforms, since NOX1 and NOX2 play a detrimental role, whereas increased NOX4 expression appears to be correlated with better HCC prognosis in some studies. Further studies are needed to fully unravel the mechanisms of action of NOXs and their relationships with the signaling pathways modulating steatosis and liver cancer development.

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“…Hepatocellular carcinoma (HCC) is the most frequent primary malignancy of the liver and has risen to become the fifth most common cancer worldwide. Due to the epidemic spread of its most important risk factors such as non-alcoholic steatohepatitis (NASH) or viral hepatitis infection, its incidence is still increasing [ 1 ]. Despite intensive research efforts, the prognosis of HCC patients is still poor and, particularly in advanced disease stages, mortality almost equals incidence.…”

Section: Introductionmentioning

confidence: 99%

Serum levels of circulating microRNA-107 are elevated in patients with early-stage HCC

et al. 2021

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Background Early detection of hepatocellular carcinoma (HCC), the most common primary liver malignancy, is crucial to offer patients a potentially curative treatment strategy such as surgical resection or liver transplantation (LT). However, easily accessible biomarkers facilitating an early diagnosis of HCC as well as a reliable risk prediction are currently missing. The microRNA(miR)-107 has recently been described as a driver of HCC in both murine and human HCC but data on circulating miR-107 in HCC patients are scarce. In the present study, we evaluated a potential diagnostic and/or prognostic role of circulating miR-107 in patients undergoing tumor resection or LT for early-stage HCC. Methods The Kmplot bioinformatic tool was used to query publicly available databases (including TCGA, GEO and EGA) in order to analyse the prognostic value of tumoral miR-107 expression in HCC patients (n = 372). Serum levels of miR-107 were measured by qPCR in n = 45 HCC patients undergoing surgical tumor resection (n = 37) or LT (n = 8) as well as n = 18 healthy control samples. Results were correlated with clinical data. Results A high tumoral expression of miR-107 was associated with a significantly better overall survival compared to patients with low miR-107 expression levels (HR 0.69, 95% CI 0.48–0.99, p = 0.041). In addition, serum levels of miR-107 were significantly higher in HCC patients when compared to healthy controls. However, miR-107 serum levels in HCC patients were independent of different disease etiology, tumor stage or tumor grading. HCC patients with baseline miR-107 expression levels above a calculated ideal prognostic cut-off value (9.82) showed a clear trend towards an impaired overall survival (p = 0.119). Conclusion Tumoral miR-107 expression levels are a potential prognostic marker in early stage HCC. Furthermore, we describe a potential role of circulating miR-107 levels as a diagnostic biomarker in patients with early-stage HCC.

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Hepatocellular carcinoma in patients with non-alcoholic steatohepatitis – epidemiology, risk factors, clinical implications and treatment

Cited by 9 publications

References 64 publications

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

The Role of Oxidative Stress in NAFLD–NASH–HCC Transition—Focus on NADPH Oxidases

Serum levels of circulating microRNA-107 are elevated in patients with early-stage HCC

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