Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Original article
Language English
Peer review Peer reviewed
Title The characteristics and risk factors of hepatocellular carcinoma in non-alcoholic fatty liver disease without cirrhosis.
Journal Formal name:Journal of gastroenterology and hepatology
Abbreviation:J Gastroenterol Hepatol
ISSN code:14401746/08159319
Volume, Issue, Page 35(5),pp.862-869
Author and coauthor ◎TOBARI Maki,HASHIMOTO Etusko, TANIAI Makiko, TOKUSHIGE Katsutoshi, KOGISO Tomomi, KODAMA Kazuhisa, YAMAMOTO Masakazu, ARAIDA Tatsuo, KATAGIRI Satoshi, NISHINO Takayoshi
Publication date 2020/05
Summary 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