Cargando…
Prevalence of the Absence of Cirrhosis in Subjects with NAFLD-Associated Hepatocellular Carcinoma
Background. Hepatocellular carcinoma (HCC) is most commonly considered as a complication of cirrhosis. However, an increasing number of HCC in subjects with non-alcoholic fatty liver disease (NAFLD) without cirrhosis is being reported. We conducted a meta-analysis to assess the prevalence of the abs...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539355/ https://www.ncbi.nlm.nih.gov/pubmed/34682759 http://dx.doi.org/10.3390/jcm10204638 |
_version_ | 1784588727133143040 |
---|---|
author | Castellana, Marco Donghia, Rossella Lampignano, Luisa Castellana, Fabio Zupo, Roberta Sardone, Rodolfo Pergola, Giovanni De Giannelli, Gianluigi |
author_facet | Castellana, Marco Donghia, Rossella Lampignano, Luisa Castellana, Fabio Zupo, Roberta Sardone, Rodolfo Pergola, Giovanni De Giannelli, Gianluigi |
author_sort | Castellana, Marco |
collection | PubMed |
description | Background. Hepatocellular carcinoma (HCC) is most commonly considered as a complication of cirrhosis. However, an increasing number of HCC in subjects with non-alcoholic fatty liver disease (NAFLD) without cirrhosis is being reported. We conducted a meta-analysis to assess the prevalence of the absence of cirrhosis in NAFLD-associated HCC. Methods. Four databases were searched until March 2021 (CRD42021242969). The original articles included were those reporting data on the presence or absence of cirrhosis among at least 50 subjects with NAFLD-associated HCC. The number of subjects with absent cirrhosis in each study was extracted. For statistical pooling of data, a random-effects model was used. Subgroup analyses according to the continent, target condition and reference standard for the diagnosis of cirrhosis were conducted. Results. Thirty studies were included, evaluating 13,371 subjects with NAFLD-associated HCC. The overall prevalence of cases without cirrhosis was 37% (95%CI 28 to 46). A higher prevalence was reported in Asia versus Europe, North America and South America (45, 36, 37 and 22%, respectively) as well as in studies adopting histology only as the reference standard for the diagnosis of cirrhosis versus histology and other modalities (e.g., radiology, endoscopy, biochemistry or overt clinical findings) (53 and 27%, respectively). No difference was found between studies including subjects with non-alcoholic steatohepatitis (NASH) only, versus NAFLD with or without NASH (p = 0.385). One in three subjects with NAFLD-associated HCC presented without cirrhosis. This should be reflected in future guidelines and surveillance programs adapted to allow for the early detection of these cancers too. |
format | Online Article Text |
id | pubmed-8539355 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-85393552021-10-24 Prevalence of the Absence of Cirrhosis in Subjects with NAFLD-Associated Hepatocellular Carcinoma Castellana, Marco Donghia, Rossella Lampignano, Luisa Castellana, Fabio Zupo, Roberta Sardone, Rodolfo Pergola, Giovanni De Giannelli, Gianluigi J Clin Med Review Background. Hepatocellular carcinoma (HCC) is most commonly considered as a complication of cirrhosis. However, an increasing number of HCC in subjects with non-alcoholic fatty liver disease (NAFLD) without cirrhosis is being reported. We conducted a meta-analysis to assess the prevalence of the absence of cirrhosis in NAFLD-associated HCC. Methods. Four databases were searched until March 2021 (CRD42021242969). The original articles included were those reporting data on the presence or absence of cirrhosis among at least 50 subjects with NAFLD-associated HCC. The number of subjects with absent cirrhosis in each study was extracted. For statistical pooling of data, a random-effects model was used. Subgroup analyses according to the continent, target condition and reference standard for the diagnosis of cirrhosis were conducted. Results. Thirty studies were included, evaluating 13,371 subjects with NAFLD-associated HCC. The overall prevalence of cases without cirrhosis was 37% (95%CI 28 to 46). A higher prevalence was reported in Asia versus Europe, North America and South America (45, 36, 37 and 22%, respectively) as well as in studies adopting histology only as the reference standard for the diagnosis of cirrhosis versus histology and other modalities (e.g., radiology, endoscopy, biochemistry or overt clinical findings) (53 and 27%, respectively). No difference was found between studies including subjects with non-alcoholic steatohepatitis (NASH) only, versus NAFLD with or without NASH (p = 0.385). One in three subjects with NAFLD-associated HCC presented without cirrhosis. This should be reflected in future guidelines and surveillance programs adapted to allow for the early detection of these cancers too. MDPI 2021-10-09 /pmc/articles/PMC8539355/ /pubmed/34682759 http://dx.doi.org/10.3390/jcm10204638 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Castellana, Marco Donghia, Rossella Lampignano, Luisa Castellana, Fabio Zupo, Roberta Sardone, Rodolfo Pergola, Giovanni De Giannelli, Gianluigi Prevalence of the Absence of Cirrhosis in Subjects with NAFLD-Associated Hepatocellular Carcinoma |
title | Prevalence of the Absence of Cirrhosis in Subjects with NAFLD-Associated Hepatocellular Carcinoma |
title_full | Prevalence of the Absence of Cirrhosis in Subjects with NAFLD-Associated Hepatocellular Carcinoma |
title_fullStr | Prevalence of the Absence of Cirrhosis in Subjects with NAFLD-Associated Hepatocellular Carcinoma |
title_full_unstemmed | Prevalence of the Absence of Cirrhosis in Subjects with NAFLD-Associated Hepatocellular Carcinoma |
title_short | Prevalence of the Absence of Cirrhosis in Subjects with NAFLD-Associated Hepatocellular Carcinoma |
title_sort | prevalence of the absence of cirrhosis in subjects with nafld-associated hepatocellular carcinoma |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539355/ https://www.ncbi.nlm.nih.gov/pubmed/34682759 http://dx.doi.org/10.3390/jcm10204638 |
work_keys_str_mv | AT castellanamarco prevalenceoftheabsenceofcirrhosisinsubjectswithnafldassociatedhepatocellularcarcinoma AT donghiarossella prevalenceoftheabsenceofcirrhosisinsubjectswithnafldassociatedhepatocellularcarcinoma AT lampignanoluisa prevalenceoftheabsenceofcirrhosisinsubjectswithnafldassociatedhepatocellularcarcinoma AT castellanafabio prevalenceoftheabsenceofcirrhosisinsubjectswithnafldassociatedhepatocellularcarcinoma AT zuporoberta prevalenceoftheabsenceofcirrhosisinsubjectswithnafldassociatedhepatocellularcarcinoma AT sardonerodolfo prevalenceoftheabsenceofcirrhosisinsubjectswithnafldassociatedhepatocellularcarcinoma AT pergolagiovannide prevalenceoftheabsenceofcirrhosisinsubjectswithnafldassociatedhepatocellularcarcinoma AT giannelligianluigi prevalenceoftheabsenceofcirrhosisinsubjectswithnafldassociatedhepatocellularcarcinoma |