ニシノ　タカヨシ   Nishino Takayoshi   西野　隆義    所属   医学部 医学科（附属八千代医療センター）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	The characteristics and risk factors of hepatocellular carcinoma in non-alcoholic fatty liver disease without cirrhosis.
掲載誌名	正式名：Journal of gastroenterology and hepatology 略　 称：J Gastroenterol Hepatol ISSNコード：14401746/08159319
巻・号・頁	35(5),pp.862-869
著者・共著者	◎TOBARI Maki,HASHIMOTO Etusko, TANIAI Makiko, TOKUSHIGE Katsutoshi, KOGISO Tomomi, KODAMA Kazuhisa, YAMAMOTO Masakazu, ARAIDA Tatsuo, KATAGIRI Satoshi, NISHINO Takayoshi
発行年月	2020/05
概要	INTRODUCTION:We evaluated the characteristics of hepatocellular carcinoma (HCC) in patients who had non-alcoholic fatty liver disease (NAFLD) without cirrhosis.METHODS:We prospectively followed NAFLD patients at our University hospital. NAFLD was diagnosed from detection of steatosis by histology or imaging, no alcohol intake, and exclusion of other liver diseases. Cirrhosis was defined by histological features, imaging data, and symptoms. We compared NAFLD-related HCC with or without cirrhosis and non-cirrhotic NAFLD with or without HCC.RESULTS:There were 48 non-cirrhotic HCC patients and 71 cirrhotic HCC patients. Multiple logistic regression analysis revealed that other than liver function factors male gender (OR: 5.603, 95%CI: 1.577-19.900), light drinker (OR: 2.797, 95%CI: 1.031-7.589), and tumor size (OR: 1.031, 95%CI 1.009-1.055) differ significantly between these two groups. The recurrence rate was significantly lower in the non-cirrhotic HCC group than the cirrhotic HCC group, with risk factors being des-γ-carboxy prothrombin and the number of HCCs. The non-cirrhotic HCC group showed significantly better survival due to absence of non-cancerous liver failure. Comparison between non-cirrhotic NAFLD patients with or without HCC (n=612) revealed the following risk factors for HCC: male gender (OR: 7.774, 95%CI: 2.176-27.775), light drinker (OR: 4.893, 95%CI: 1.923-12.449), and high FIB4-index (OR 2.634, 95%CI: 1.787-3.884).CONCLUSION:In patients with non-cirrhotic NAFLD, important risk factors for HCC were male gender, alcohol consumption, and the FIB4-index. HCC recurrence and survival were only influenced by the tumor stage. We should be aware of alcohol consumption as a modifiable risk factor for HCC.
DOI	10.1111/jgh.14867
PMID	31597206