代谢功能障碍伴脂肪肝患者的肝细胞癌风险预测和早期检测。

IF 3.8 Q2 GASTROENTEROLOGY & HEPATOLOGY
Translational gastroenterology and hepatology Pub Date : 2024-10-12 eCollection Date: 2024-01-01 DOI:10.21037/tgh-24-41
Jeff Liang, Naomy Kim, Ju Dong Yang
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引用次数: 0

摘要

代谢功能障碍相关性脂肪性肝病(MASLD)及其更严重的代谢功能障碍相关性脂肪性肝炎(MASH)发病率的上升与肝细胞癌(HCC)风险的增加密切相关,而肝细胞癌是全球癌症相关死亡的第四大原因。尽管 MASLD 患者罹患 HCC 的风险较高,但现有的监测指南并不完善,尤其是对于那些没有肝硬化的患者。本综述评估了目前对 MASLD 患者进行 HCC 监测的做法及其不足之处。文章还强调了通过新技术提高 HCC 风险分层和诊断准确性的迫切需要。在这篇综述文章中,我们对 2000 年至 2023 年有关 MASLD/MASH 患者 HCC 风险因素的研究进行了全面的文献综述。我们讨论了人口统计学、合并症、肝纤维化和遗传标记在 HCC 风险分层中的关键作用。此外,无创肝纤维化检测(NIT)可提高HCC风险分层和诊断的准确性。最近,机器学习技术和利用细胞外囊泡、无细胞 DNA 和循环肿瘤细胞的液体活检等创新方法有望重新定义早期 HCC 检测。因此,整合这些不同的风险因素可以优化对日益增多的MASLD/MASH患者群体的HCC早期检测。然而,还需要进一步的研究来证实它们的有效性以及在临床环境中的实际应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hepatocellular carcinoma risk prediction and early detection in patients with metabolic dysfunction associated steatotic liver disease.

The rising prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and its more severe form, metabolic dysfunction-associated steatohepatitis (MASH), is closely linked with a heightened risk of hepatocellular carcinoma (HCC), the fourth leading cause of cancer-related deaths worldwide. Despite the elevated risk of HCC in patients with MASLD, the existing surveillance guidelines are inadequate, particularly for those without cirrhosis. This review evaluates current HCC surveillance practices in patients with MASLD and their shortcomings. It also highlights the critical need for enhanced HCC risk stratification and diagnostic accuracy through new techniques. In this review article, we performed a comprehensive literature review of studies focusing on HCC risk factors in MASLD/MASH patients from 2000 to 2023. We discussed that demographics, comorbidities, liver fibrosis, and genetic markers play critical roles in HCC risk stratification. Additionally, non-invasive tests (NITs) for fibrosis may improve the accuracy for HCC risk stratification and diagnosis. More recently, innovative approaches, such as machine learning techniques and liquid biopsy utilizing extracellular vesicles, cell-free DNA, and circulating tumor cells show promise in redefining early HCC detection. Thus, integrating these various risk factors could optimize early detection of HCC for the growing MASLD/MASH patient population. However, further research is needed to confirm their effectiveness and practical implementation in clinical settings.

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