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Nonalcoholic steatohepatitis and hepatocellular carcinoma: Brazilian survey
OBJECTIVE: The majority of cases of hepatocellular carcinoma have been reported in individuals with cirrhosis due to chronic viral hepatitis and alcoholism, but recently, the prevalence has become increasingly related to nonalcoholic steatohepatitis around the world. The study aimed to evaluate the...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4874267/ https://www.ncbi.nlm.nih.gov/pubmed/27276398 http://dx.doi.org/10.6061/clinics/2016(05)07 |
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author | Cotrim, Helma P. Oliveira, Claudia P. Coelho, Henrique Sérgio M. Alvares-da-Silva, Mario R. Nabuco, Leticia Parise, Edison Roberto Ivantes, Claúdia Martinelli, Ana LC Galizzi-Filho, João Carrilho, Flair J. |
author_facet | Cotrim, Helma P. Oliveira, Claudia P. Coelho, Henrique Sérgio M. Alvares-da-Silva, Mario R. Nabuco, Leticia Parise, Edison Roberto Ivantes, Claúdia Martinelli, Ana LC Galizzi-Filho, João Carrilho, Flair J. |
author_sort | Cotrim, Helma P. |
collection | PubMed |
description | OBJECTIVE: The majority of cases of hepatocellular carcinoma have been reported in individuals with cirrhosis due to chronic viral hepatitis and alcoholism, but recently, the prevalence has become increasingly related to nonalcoholic steatohepatitis around the world. The study aimed to evaluate the clinical and histophatological characteristics of hepatocellular carcinoma in Brazilians' patients with nonalcoholic steatohepatitis at the present time. METHODS: Members of the Brazilian Society of Hepatology were invited to complete a survey regarding patients with hepatocellular carcinoma related to nonalcoholic steatohepatitis. Patients with a history of alcohol intake (>20 g/day) and other liver diseases were excluded. Hepatocellular carcinoma diagnosis was performed by liver biopsy or imaging methods according to the American Association for the Study of Liver Diseases' 2011 guidelines. RESULTS: The survey included 110 patients with a diagnosis of hepatocellular carcinoma and nonalcoholic fatty liver disease from nine hepatology units in six Brazilian states (Bahia, Minas Gerais, Rio de Janeiro, São Paulo, Paraná and Rio Grande do Sul). The mean age was 67±11 years old, and 65.5% were male. Obesity was observed in 52.7% of the cases; diabetes, in 73.6%; dyslipidemia, in 41.0%; arterial hypertension, in 60%; and metabolic syndrome, in 57.2%. Steatohepatitis without fibrosis was observed in 3.8% of cases; steatohepatitis with fibrosis (grades 1-3), in 27%; and cirrhosis, in 61.5%. Histological diagnosis of hepatocellular carcinoma was performed in 47.2% of the patients, with hepatocellular carcinoma without cirrhosis accounting for 7.7%. In total, 58 patients with cirrhosis had their diagnosis by ultrasound confirmed by computed tomography or magnetic resonance imaging. Of these, 55% had 1 nodule; 17%, 2 nodules; and 28%, ≥3 nodules. CONCLUSIONS: Nonalcoholic steatohepatitis is a relevant risk factor associated with hepatocellular carcinoma in patients with and without cirrhosis in Brazil. In this survey, hepatocellular carcinoma was observed in elevated numbers of patients with steatohepatitis without cirrhosis. |
format | Online Article Text |
id | pubmed-4874267 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo |
record_format | MEDLINE/PubMed |
spelling | pubmed-48742672016-06-07 Nonalcoholic steatohepatitis and hepatocellular carcinoma: Brazilian survey Cotrim, Helma P. Oliveira, Claudia P. Coelho, Henrique Sérgio M. Alvares-da-Silva, Mario R. Nabuco, Leticia Parise, Edison Roberto Ivantes, Claúdia Martinelli, Ana LC Galizzi-Filho, João Carrilho, Flair J. Clinics (Sao Paulo) Clinical Science OBJECTIVE: The majority of cases of hepatocellular carcinoma have been reported in individuals with cirrhosis due to chronic viral hepatitis and alcoholism, but recently, the prevalence has become increasingly related to nonalcoholic steatohepatitis around the world. The study aimed to evaluate the clinical and histophatological characteristics of hepatocellular carcinoma in Brazilians' patients with nonalcoholic steatohepatitis at the present time. METHODS: Members of the Brazilian Society of Hepatology were invited to complete a survey regarding patients with hepatocellular carcinoma related to nonalcoholic steatohepatitis. Patients with a history of alcohol intake (>20 g/day) and other liver diseases were excluded. Hepatocellular carcinoma diagnosis was performed by liver biopsy or imaging methods according to the American Association for the Study of Liver Diseases' 2011 guidelines. RESULTS: The survey included 110 patients with a diagnosis of hepatocellular carcinoma and nonalcoholic fatty liver disease from nine hepatology units in six Brazilian states (Bahia, Minas Gerais, Rio de Janeiro, São Paulo, Paraná and Rio Grande do Sul). The mean age was 67±11 years old, and 65.5% were male. Obesity was observed in 52.7% of the cases; diabetes, in 73.6%; dyslipidemia, in 41.0%; arterial hypertension, in 60%; and metabolic syndrome, in 57.2%. Steatohepatitis without fibrosis was observed in 3.8% of cases; steatohepatitis with fibrosis (grades 1-3), in 27%; and cirrhosis, in 61.5%. Histological diagnosis of hepatocellular carcinoma was performed in 47.2% of the patients, with hepatocellular carcinoma without cirrhosis accounting for 7.7%. In total, 58 patients with cirrhosis had their diagnosis by ultrasound confirmed by computed tomography or magnetic resonance imaging. Of these, 55% had 1 nodule; 17%, 2 nodules; and 28%, ≥3 nodules. CONCLUSIONS: Nonalcoholic steatohepatitis is a relevant risk factor associated with hepatocellular carcinoma in patients with and without cirrhosis in Brazil. In this survey, hepatocellular carcinoma was observed in elevated numbers of patients with steatohepatitis without cirrhosis. Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2016-05 2016-05 /pmc/articles/PMC4874267/ /pubmed/27276398 http://dx.doi.org/10.6061/clinics/2016(05)07 Text en Copyright © 2016 CLINICS http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Science Cotrim, Helma P. Oliveira, Claudia P. Coelho, Henrique Sérgio M. Alvares-da-Silva, Mario R. Nabuco, Leticia Parise, Edison Roberto Ivantes, Claúdia Martinelli, Ana LC Galizzi-Filho, João Carrilho, Flair J. Nonalcoholic steatohepatitis and hepatocellular carcinoma: Brazilian survey |
title | Nonalcoholic steatohepatitis and hepatocellular carcinoma: Brazilian survey |
title_full | Nonalcoholic steatohepatitis and hepatocellular carcinoma: Brazilian survey |
title_fullStr | Nonalcoholic steatohepatitis and hepatocellular carcinoma: Brazilian survey |
title_full_unstemmed | Nonalcoholic steatohepatitis and hepatocellular carcinoma: Brazilian survey |
title_short | Nonalcoholic steatohepatitis and hepatocellular carcinoma: Brazilian survey |
title_sort | nonalcoholic steatohepatitis and hepatocellular carcinoma: brazilian survey |
topic | Clinical Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4874267/ https://www.ncbi.nlm.nih.gov/pubmed/27276398 http://dx.doi.org/10.6061/clinics/2016(05)07 |
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