Clinical Gastroenterology Vol.33 No.1(10)

Theme NASH 2018
Title The Actual Situation of Hepato-carcinogenesis in Nonalcoholic Steatohepatitis
Publish Date 2018/01
Author Yoshito Itoh Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine
Author Kanji Yamaguchi Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine
Author Atsushi Umemura Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine
Author Michihisa Moriguchi Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine
Author Tasuku Hara Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine
Author Yuya Seko Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine
[ Summary ] Nonalcoholic fatty liver disease (NAFLD)‒hepatocellular carcinoma (HCC) is estimated to account for 2.0 % of the total HCC cases in Japan. The annual incidence of HCC in NAFLD after a health check‒up has been reported to be low, whereas its incidence in liver cirrhosis is around 2‒3 %. Non‒B non‒C HCC accounted for 10 % of the total HCC cases, which recently exceeded 20 %, presumably attributed to an increase in the incidence of obesity. Metabolic syndrome not only causes NAFLD / nonalcoholic steatohepatitis (NASH) but also may accelerate hepato‒carcinogenesis. HCC ranks at the top among the cancers associated with diabetes mellitus and its risk ratio is 2.5. Polymorphisms in PNPLA3 rs738409 are associated with hepatic steatosis as well as fibrosis with its risk allele G. A report from Europe, as well as our data, indicated that PNPLA3 rs738409 GG contributed not only to hepatic steatosis and fibro‒genesis but also to hepato‒carcinogenesis.
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