Tovo CV, de Mattos AZ, Coral GP, Sartori GDP, Nogueira LV, Both GT, Villela-Nogueira CA, de Mattos AA. Hepatocellular carcinoma in non-alcoholic steatohepatitis without cirrhosis. World J Gastroenterol 2023; 29(2): 343-356 [PMID: 36687125 DOI: 10.3748/wjg.v29.i2.343]
Corresponding Author of This Article
Cristiane Valle Tovo, MD, PhD, Associate Professor, Internal Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite 245, Porto Alegre 90050170, RS, Brazil. cris.tovo@terra.com.br
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jan 14, 2023; 29(2): 343-356 Published online Jan 14, 2023. doi: 10.3748/wjg.v29.i2.343
Hepatocellular carcinoma in non-alcoholic steatohepatitis without cirrhosis
Cristiane Valle Tovo, Angelo Zambam de Mattos, Gabriela Perdomo Coral, Giovana D P Sartori, Livia Villela Nogueira, Gustavo Tovo Both, Cristiane A Villela-Nogueira, Angelo A de Mattos
Cristiane Valle Tovo, Angelo Zambam de Mattos, Gabriela Perdomo Coral, Giovana D P Sartori, Angelo A de Mattos, Department of Internal Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre 90050170, RS, Brazil
Livia Villela Nogueira, Department of Internal Medicine, Fundação Técnico Educacional Souza Marques, RJ 21491-630, RJ, Brazil
Gustavo Tovo Both, Department of Internal Medicine, Universidade Luterana do Brasil, Canoas 92425-350, RS, Brazil
Cristiane A Villela-Nogueira, Department of Internal Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21491-630, RJ, Brazil
Author contributions: Tovo CV and de Mattos AA conceptualized the study; all authors contributed equally to drafting the article and making critical revisions related to important intellectual content of the manuscript; and all authors approved the final version of the article to be published.
Conflict-of-interest statement: There is no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cristiane Valle Tovo, MD, PhD, Associate Professor, Internal Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite 245, Porto Alegre 90050170, RS, Brazil. cris.tovo@terra.com.br
Received: September 12, 2022 Peer-review started: September 12, 2022 First decision: October 4, 2022 Revised: October 7, 2022 Accepted: November 18, 2022 Article in press: November 18, 2022 Published online: January 14, 2023 Processing time: 115 Days and 4.3 Hours
Abstract
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.
Core Tip: 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. In the present study, we evaluated data regarding the epidemiology, the pathophysiology, the histopathological aspects, the current recommendations, and novel perspectives in the surveillance of non-cirrhotic NAFLD-related HCC. We believe that using non-invasive methods can guide the selection of patients who need to undergo screening and a surveillance program.
