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Review
. 2023 Jan 14;29(2):343-356.
doi: 10.3748/wjg.v29.i2.343.

Hepatocellular carcinoma in non-alcoholic steatohepatitis without cirrhosis

Cristiane Valle Tovo  1 , Angelo Zambam de Mattos  2 , Gabriela Perdomo Coral  2 , Giovana D P Sartori  2 , Livia Villela Nogueira  3 , Gustavo Tovo Both  4 , Cristiane A Villela-Nogueira  5 , Angelo A de Mattos  2
Affiliations
Review

Hepatocellular carcinoma in non-alcoholic steatohepatitis without cirrhosis

Cristiane Valle Tovo et al. World J Gastroenterol. .

Abstract

Cirrhosis is an emerging major cause of the development of hepatocellular carcinoma (HCC), but in non-alcoholic fatty liver disease (NAFLD), up to 50% of patients with HCC had no clinical or histological evidence of cirrhosis. It is currently challenging to propose general recommendations for screening patients with NAFLD without cirrhosis, and each patient should be evaluated on a case-by-case basis based on the profile of specific risk factors identified. For HCC screening in NAFLD, a valid precision-based screening is needed. Currently, when evaluating this population of patients, the use of non-invasive methods can guide the selection of those who should undergo a screening and surveillance program. Hence, the objective of the present study is to review the epidemiology, the pathophysiology, the histopathological aspects, the current recommendations, and novel perspectives in the surveillance of non-cirrhotic NAFLD-related HCC.

Keywords: Genetic variants; Hepatocellular carcinoma; Microbiota; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Obesity.

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Conflict of interest statement

Conflict-of-interest statement: There is no conflict of interest.

Figures

Figure 1
Figure 1
Histopathological aspect of a non-alcoholic fatty liver disease-related hepatocellular carcinoma in a non-cirrhotic liver. On the left side: Non-cirrhotic liver with steatosis. On the right side: Hepatocellular carcinoma, steatohepatitis variant with steatosis, hepatocellular ballooning and macro-trabecular arrangement.
See this image and copyright information in PMC

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