title: Liver Cancer: Connections with Obesity, Fatty Liver, and Cirrhosis.
abstract: The burden of hepatocellular carcinoma (HCC), the most common form of liver cancer, is steadily growing because obesity, type 2 diabetes, and nonalcoholic fatty liver disease (NAFLD) are replacing viral- and alcohol-related liver disease as major pathogenic promoters. The most worrisome aspects of these new risk factors are their large spread in the general population and their link with HCC arising in noncirrhotic livers. HCC may be the presenting feature of an asymptomatic nonalcoholic steatohepatitis (NASH), the progressive form of NAFLD. The HCC risk connected to metabolic factors has been underestimated so far, and a poorer surveillance has prevented an adequate treatment. Systemic and hepatic molecular mechanisms involved in obesity- and NAFLD-induced hepatocarcinogenesis as well as potential early markers of HCC are being extensively investigated. This review summarizes current evidence linking obesity, NAFLD and liver cancer, discusses its clinical impact and describes the main mechanisms underlying this complex relationship.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medical Sciences, A.O. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy; email: elisabetta.bugianesi@unito.it , amarengo@unito.it , crosso@cittadellasalute.to.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Marengo
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medical Sciences, A.O. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy; email: elisabetta.bugianesi@unito.it , amarengo@unito.it , crosso@cittadellasalute.to.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Rosso
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medical Sciences, A.O. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy; email: elisabetta.bugianesi@unito.it , amarengo@unito.it , crosso@cittadellasalute.to.it.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Bugianesi
mesh_terms: D054392:Adipokines / Q000378:metabolism; D063646:Carcinogenesis / Q000235:genetics / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000628:therapy; D016207:Cytokines / Q000378:metabolism; D004032:Diet; D055088:Early Detection of Cancer; D000069196:Gastrointestinal Microbiome; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D008103:Liver Cirrhosis / Q000209:etiology; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000628:therapy; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000453:epidemiology; D009765:Obesity / Q000150:complications* / Q000453:epidemiology
chemical_list: D054392:Adipokines; D016207:Cytokines
keywords: hepatocarcinogenesis; hepatocellular carcinoma; steatohepatitis; type 2 diabetes