title: Hepatocellular carcinoma and non-alcoholic fatty liver disease: from a clinical to a molecular association.
abstract: Hepatocellular carcinoma (HCC) is the most frequent primary neoplasm of the liver, and is the fourth most common malignancy worldwide. It is also the third leading cause of cancer-related deaths. Most cases of HCC develop on a pre-existing chronic liver disease, usually due to hepatitis C virus (HCV), hepatitis B virus (HBV), or alcohol. However, between 15% and 50% of HCC develops in the absence of a known etiology of liver disease, and different lines of evidence identify in non-alcoholic fatty liver disease (NAFLD) a possible relevant risk factor for occurrence of HCC. Insulin resistance (IR), steatosis, oxidative stress and imbalances in adipokine/cytokine interplay, the most important factors involved in NAFLD pathogenesis and progression, could also have a determinant role in liver carcinogenesis by promoting cellular growth and DNA damage. Recently, behavioral therapy and various insulin sensitizing agents have been tested in the treatment of NAFLD. A number of studies suggest that these approaches improve IR and reduce steatosis, necroinflammation and fibrosis. A potential role of these therapeutic strategies in the prevention of hepatocarcinogenesis can thus be envisaged.
authors.affiliation: Cattedra ed Unità Operativa di Gastroenterologia, DiBiMIS, University of Palermo, Italy. petsa@inwind.it
authors.forename: S
authors.initials: S
authors.lastname: Petta
authors.forename: A
authors.initials: A
authors.lastname: Craxì
mesh_terms: D000818:Animals; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000235:genetics / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000235:genetics / Q000378:metabolism; D005234:Fatty Liver / Q000209:etiology / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D008108:Liver Diseases, Alcoholic; D008113:Liver Neoplasms / Q000209:etiology / Q000235:genetics / Q000378:metabolism*; D009765:Obesity / Q000150:complications / Q000235:genetics / Q000378:metabolism; D012307:Risk Factors