Nonalcoholic fatty liver disease and hepatocellular carcinoma

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.