Hepatocellular carcinoma in non-alcoholic steatohepatitis without cirrhosis

• Published in: World journal of gastroenterology : WJG Vol. 29; no. 2; pp. 343 - 356
• Main Authors: Tovo, Cristiane Valle, de Mattos, Angelo Zambam, Coral, Gabriela Perdomo, Sartori, Giovana D P, Nogueira, Livia Villela, Both, Gustavo Tovo, Villela-Nogueira, Cristiane A, de Mattos, Angelo A
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 14.01.2023
• Subjects: Carcinoma, Hepatocellular - diagnosis; Carcinoma, Hepatocellular - epidemiology; Carcinoma, Hepatocellular - etiology; Fibrosis; Humans; Liver Cirrhosis - complications; Liver Cirrhosis - diagnosis; Liver Cirrhosis - epidemiology; Liver Neoplasms - diagnosis; Liver Neoplasms - epidemiology; Liver Neoplasms - etiology; Minireviews; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - diagnosis; Non-alcoholic Fatty Liver Disease - epidemiology; Risk Factors; Obesity; Hepatocellular carcinoma; Microbiota; Genetic variants; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis
• ISSN: 1007-9327; 2219-2840; 2219-2840
• DOI: 10.3748/wjg.v29.i2.343

Cirrhosis is an emerging major cause of the development of hepatocellular carcinoma (HCC), but in non-alcoholic fatty liver disease (NAFLD), up to 50% of patients with HCC had no clinical or histological evidence of cirrhosis. It is currently challenging to propose general recommendations for screening patients with NAFLD without cirrhosis, and each patient should be evaluated on a case-by-case basis based on the profile of specific risk factors identified. For HCC screening in NAFLD, a valid precision-based screening is needed. Currently, when evaluating this population of patients, the use of non-invasive methods can guide the selection of those who should undergo a screening and surveillance program. Hence, the objective of the present study is to review the epidemiology, the pathophysiology, the histopathological aspects, the current recommendations, and novel perspectives in the surveillance of non-cirrhotic NAFLD-related HCC.