Opinion Review
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2025; 31(5): 97500
Published online Feb 7, 2025. doi: 10.3748/wjg.v31.i5.97500
What is the role of nonalcoholic fatty liver disease in pulmonary carcinoma development?
Qin Pan, Qing-Yang Xu, Lang-Hua Zhang, Ya-Fang He
Qin Pan, Shanghai Institute of Pediatric Research, Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, China
Qin Pan, Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, China
Qin Pan, School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
Qing-Yang Xu, Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
Lang-Hua Zhang, School of Medical Technology, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
Ya-Fang He, Department of Pediatric Respiratory, Xinhua Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, China
Co-first authors: Qin Pan and Qing-Yang Xu.
Co-corresponding authors: Lang-Hua Zhang and Ya-Fang He.
Author contributions: Pan Q, Xu QY, Zhang LH, and He YF contributed to this paper; Pan Q and Xu QY contributed equally in designing the concept, collecting literatures, and outlining the manuscript as co-first authors; Zhang LH and He YF contributed equally in supervising, reviewing, and revising the manuscript as co-corresponding authors.
Supported by National Science and Technology Major Project of China, No. 2023ZD0508700; National Natural Science Foundation of China, No. 81470859; and Program of Taizhou Science and Technology Grant, No. 24ywb33.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Ya-Fang He, PhD, Department of Pediatric Respiratory, Xinhua Hospital, Shanghai Jiao Tong University, School of Medicine, No. 1665 Kongjiang Road, Shanghai 200092, China. heyafang@xinhuamed.com.cn
Received: May 31, 2024
Revised: November 2, 2024
Accepted: December 9, 2024
Published online: February 7, 2025
Processing time: 212 Days and 22.9 Hours
Abstract

This article summarizes the epidemiological characteristics and clinical manifestations of nonalcoholic fatty liver disease (NAFLD). The incidence of NAFLD has been increased dramatically and become the leading cause of chronic liver disease worldwide. In addition to its adverse outcomes of liver fibrosis, cirrhosis, and hepatocellular carcinoma, and related complications, NAFLD has recently been found to be associated with the high-risk extrahepatic carcinomas, such as various types of lung cancer (i.e., lung adenocarcinoma, squamous cell carcinoma, and small cell lung cancer). The presence of hepatic steatosis also predisposes lung cancer to liver metastasis, but has better response to immune checkpoint inhibitors. Whether other factors (i.e., gender, smoking, etc.) are associated with NAFLD and lung cancer remains controversial. We also comment on the reciprocal relationships between NAFLD and components of metabolic syndrome. Most metabolic syndrome components are suggested to facilitate lung cancer development via activating insulin/insulin-like growth factor axis. In addition, suppressed anti-tumor immunity and accelerated tumor progression could be attributed to the cell-specific metabolic reprogramming in condition of high-fat diet and related obesity. These findings may reveal the role of NAFLD in pulmonary carcinoma and help develop new treatment strategies for this disease.

Keywords: Nonalcoholic fatty liver disease; Lung; Cancer; Adenocarcinoma; Metabolic syndrome; Component

Core Tip: The increasing incidence of nonalcoholic fatty liver disease (NAFLD) has led to a public health burden, which is even worse due to its close association with lung cancer. Limited understanding of this phenomenon hinders the prevention, diagnosis, and treatment of NAFLD-related lung cancer. This article presents the effects of NAFLD on the progression, pathological subtypes, metastasis, and treatment response of lung cancer. Moreover, the mechanisms underlying the NAFLD-related metabolic disorders, metabolic syndrome-dependent immune impairment and tumor growth are discussed. These findings may provide insights into the role of NAFLD in pulmonary carcinoma, and highlights new treatment strategies for this disease.