title: Nonalcoholic steatohepatitis and noncirrhotic hepatocellular carcinoma: fertile soil.
abstract: Nonalcoholic fatty liver disease (NAFLD) is easily the most common cause of chronic liver disease in the United States (U.S.) as the hepatic manifestation of the metabolic syndrome. Although only 5 to 20% of patients with NAFLD are generally considered to meet criteria for nonalcoholic steatohepatitis (NASH), with its inherent risk for progression to cirrhosis, this still represents an alarmingly large number of individuals. The exponentially growing rates of hepatocellular carcinoma (HCC) in the U.S. may be partially attributable to increased numbers of NASH cirrhotics, although recent evidence has suggested that NAFLD may directly promote hepatic carcinogenesis independent of cirrhosis. This review focuses on HCC in noncirrhotic NASH with an emphasis on clinical presentation, pathogenesis, and implications for screening.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Walter Reed National Military Medical Center, Washington, DC, USA.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Torres
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Harrison
mesh_terms: D055372:AMP-Activated Protein Kinases; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D002471:Cell Transformation, Neoplastic / Q000276:immunology / Q000378:metabolism; D000090702:Constitutive Androstane Receptor; D016207:Cytokines; D048909:Diabetes Complications / Q000150:complications; D005234:Fatty Liver / Q000150:complications* / Q000378:metabolism; D006801:Humans; D007333:Insulin Resistance; D019190:Iron Overload / Q000150:complications; D008113:Liver Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D035683:MicroRNAs; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000150:complications / Q000378:metabolism; D018384:Oxidative Stress; D051059:PTEN Phosphohydrolase; D018160:Receptors, Cytoplasmic and Nuclear; D012307:Risk Factors; D015398:Signal Transduction; D051193:Toll-Like Receptors
chemical_list: D000090702:Constitutive Androstane Receptor; D016207:Cytokines; D035683:MicroRNAs; D018160:Receptors, Cytoplasmic and Nuclear; D051193:Toll-Like Receptors; D055372:AMP-Activated Protein Kinases; D051059:PTEN Phosphohydrolase; C494929:PTEN protein, human