Non-Alcoholic steatohepatitis and primary hepatic carcinoma

Abstract

SUMMARY
Non-alcoholic fatty liver disease (NAFLD) has been recognized
as the most frequent cause of chronic liver disease
and comprises a spectrum of chronic liver diseases ranging
from simple hepatic steatosis, to hepatic steatosis with
non-specific hepatic inflammation, to non-alcoholic steatohepatitis
(NASH) and finally cirrhosis. Few reports have
been published so far about the incidence of primary hepatic
carcinoma in patients with NAFLD and NASH. The
importance of these findings remains to be defined, but one
could speculate that hepatocellular carcinoma is part of
the clinical spectrum of NAFLD and the metabolic derangement
observed in patients with NAFLD may underlie the
progression of liver disease to cirrhosis and hepatocellular
carcinoma. Attempts should be made to interrupt the progression
from simple fatty liver disease to steatohepatitis,
fibrosis, cirrhosis and ultimately hepatocellular carcinoma.
A behavioral approach, such as diet and exercise, to reduce
the prevalence and the progression of obesity, diabetes and
dyslipidemia, as well as the pharmacologic treatment of
insulin resistance and the use of newer therapeutic agents
of NASH, merit consideration in this clinical setting.