An updated overview on hepatocellular carcinoma in patients with Metabolic dysfunction-Associated Steatotic Liver Disease: Trends, pathophysiology and risk-based surveillance.

IF 10.8 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Metabolism: clinical and experimental Pub Date : 2024-11-19 DOI:10.1016/j.metabol.2024.156080

Angelo Armandi, Chiara Rosso, Gian Paolo Caviglia, Elisabetta Bugianesi

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Abstract

Hepatocellular carcinoma (HCC) is a relevant complication occurring in individuals with advanced Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD). Recent epidemiological data suggest an alarming increase in the HCC burden worldwide, with a relevant proportion attributable to MASLD (up to 38 %), either in cirrhotic or non-cirrhotic livers. In view of the changing landscape of metabolic syndrome as "silent pandemic", this narrative review aims to provide an updated picture of the burden of HCC in individuals with MASLD. In the complex pathophysiological pathways linking insulin resistance to MASLD and cardiometabolic syndrome, metabolic inflammation appears a relevant driver of systemic as well as organ-specific complications. Novel insights from the field of immunology, gut-derived liver damage, and association with extra-hepatic cancers will be discussed. Finally, strategies for risk-based HCC surveillance (circulating biomarkers, prognostic models and polygenic risk scores) will be provided and the potential impact of novel drug targeting fibrosing Metabolic dysfunction-Associated Steatohepatitis (MASH) on incident HCC will be discussed.

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代谢功能障碍相关性脂肪肝患者肝细胞癌的最新概述：趋势、病理生理学和基于风险的监控。

肝细胞癌（HCC）是晚期代谢功能障碍相关性脂肪性肝病（MASLD）患者的一种相关并发症。最近的流行病学数据表明，全球范围内的 HCC 负担正以惊人的速度增加，其中有相当一部分可归因于 MASLD（高达 38%），无论是肝硬化还是非肝硬化。鉴于代谢综合征作为 "无声流行病 "的形势不断变化，本综述旨在提供有关 MASLD 患者 HCC 负担的最新情况。在将胰岛素抵抗与 MASLD 和心脏代谢综合征联系起来的复杂病理生理途径中，代谢性炎症似乎是全身性和器官特异性并发症的相关驱动因素。还将讨论免疫学、肠道源性肝损伤以及与肝外癌症的关联等领域的新见解。最后，将提供基于风险的 HCC 监测策略（循环生物标志物、预后模型和多基因风险评分），并讨论针对纤维化代谢功能障碍相关性脂肪性肝炎（MASH）的新型药物对 HCC 发病的潜在影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Metabolism: clinical and experimental 医学-内分泌学与代谢

CiteScore

18.90

自引率

3.10%

发文量

310

审稿时长

16 days

期刊介绍： Metabolism upholds research excellence by disseminating high-quality original research, reviews, editorials, and commentaries covering all facets of human metabolism. Consideration for publication in Metabolism extends to studies in humans, animal, and cellular models, with a particular emphasis on work demonstrating strong translational potential. The journal addresses a range of topics, including: - Energy Expenditure and Obesity - Metabolic Syndrome, Prediabetes, and Diabetes - Nutrition, Exercise, and the Environment - Genetics and Genomics, Proteomics, and Metabolomics - Carbohydrate, Lipid, and Protein Metabolism - Endocrinology and Hypertension - Mineral and Bone Metabolism - Cardiovascular Diseases and Malignancies - Inflammation in metabolism and immunometabolism