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From NASH to HCC: current concepts and future challenges

Lookup NU author(s): Professor Quentin Anstee, Professor Helen Reeves, Dr Olivier Govaere

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Abstract

© 2019, Springer Nature Limited. Caloric excess and sedentary lifestyle have led to a global epidemic of obesity and metabolic syndrome. The hepatic consequence of metabolic syndrome and obesity, nonalcoholic fatty liver disease (NAFLD), is estimated to affect up to one-third of the adult population in many developed and developing countries. This spectrum of liver disease ranges from simple steatosis to nonalcoholic steatohepatitis (NASH) and cirrhosis. Owing to the high prevalence of NAFLD, especially in industrialized countries but also worldwide, and the consequent burden of progressive liver disease, there is mounting epidemiological evidence that NAFLD has rapidly become a leading aetiology underlying many cases of hepatocellular carcinoma (HCC). In this Review, we discuss NAFLD-associated HCC, including its epidemiology, the key features of the hepatic NAFLD microenvironment (for instance, adaptive and innate immune responses) that promote hepatocarcinogenesis and the management of HCC in patients with obesity and associated metabolic comorbidities. The challenges and future directions of research will also be discussed, including clinically relevant biomarkers for early detection, treatment stratification and monitoring as well as approaches to therapies for both prevention and treatment in those at risk or presenting with NAFLD-associated HCC.


Publication metadata

Author(s): Anstee QM, Reeves HL, Kotsiliti E, Govaere O, Heikenwalder M

Publication type: Review

Publication status: Published

Journal: Nature Reviews Gastroenterology and Hepatology

Year: 2019

Pages: Epub ahead of print

Online publication date: 26/04/2019

Acceptance date: 02/04/2018

ISSN (print): 1759-5045

ISSN (electronic): 1759-5053

Publisher: Nature Publishing Group

URL: https://doi.org/10.1038/s41575-019-0145-7

DOI: 10.1038/s41575-019-0145-7


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