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非酒精性脂肪性肝病与肝细胞癌
Nonalcoholic fatty liver disease and hepatocellular carcinoma
文章发布日期:2016年02月06日  来源:  作者:李良平  点击次数:1498次  下载次数:298次

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【摘要】:肝细胞癌(HCC)的病因正在悄然发生变化,欧美发达国家及部分亚洲国家非酒精性脂肪性肝病(NAFLD)相关HCC发病率逐渐增加。介绍了NAFLD与相关HCC的密切关系,NAFLD相关HCC的危险因素、临床病理特征及预防和筛查,指出NAFLD发病率尽管不如乙型肝炎和丙型肝炎相关HCC高,但因NAFLD基数大,其绝对数量不在少数,尤其是合并糖尿病和肥胖或肝纤维化/肝硬化高危患者。NAFLD相关HCC多见于老年,合并症较多,整体预后不佳。认为预防的重点在于有效治疗NAFLD,对高危人群进行严密筛查以便发现早期HCC,甲胎蛋白及CT等影像检查是主要的筛查方法,但目前尚缺乏针对NAFLD相关HCC早期预警的措施。
【Abstract】:As the etiology of hepatocellular carcinoma (HCC) has been changing, the incidence of HCC related to nonalcoholic fatty liver disease (NAFLD) is gradually increasing in developed countries in Europe and America and some countries in Asia. This article introduces the close association between NAFLD and HCC, risk factors, clinicopathological features, and prevention and screening, and points out that although the incidence of NAFLD is not as high as that of hepatitis B- or hepatitis C-related HCC, there are a large absolute number of NAFLD patients, especially the high-risk patients with diabetes and obesity, or liver fibrosis/cirrhosis, due to a huge base number of NAFLD patients. NAFLD-related HCC is commonly seen in the elderly with various comorbidities and a poor prognosis. This article also points out that the prevention should focus on the effective treatment of NAFLD. The strict screening of high-risk population is the strategy for the diagnosis of early-stage HCC. At present, the sensitivity of alpha-fetoprotein is relatively low, and imaging examinations including computed tomography are the main screening methods; however, there are no measures for early warning of NAFLD-related HCC.
【关键字】:脂肪肝;癌,肝细胞;代谢综合征X
【Key words】:fatty liver; carcinoma, hepatocellular; metabolic syndrome X
【引证本文】:李良平. 非酒精性脂肪性肝病与肝细胞癌[J]. 临床肝胆病杂志, 2016, 32(3): 432-436.

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