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Comparative Study
. 2015 Jan 28;21(4):1189-96.
doi: 10.3748/wjg.v21.i4.1189.

Characteristics of hepatocellular carcinoma in cirrhotic and non-cirrhotic non-alcoholic fatty liver disease

Christopher Leung  1 , Sern Wei Yeoh  1 , Desmond Patrick  1 , Shara Ket  1 , Kaye Marion  1 , Paul Gow  1 , Peter W Angus  1
Affiliations
Comparative Study

Characteristics of hepatocellular carcinoma in cirrhotic and non-cirrhotic non-alcoholic fatty liver disease

Christopher Leung et al. World J Gastroenterol. .

Abstract

Aim: To determine characteristics and prognostic predictors of patients with hepatocellular carcinoma (HCC) in association with non-alcoholic fatty liver disease (NAFLD).

Methods: We reviewed the records of all patients with NAFLD associated HCC between 2000 and 2012. Data collected included demographics; histology; presence or absence of cirrhosis, size and number of HCC, alpha-fetoprotein, body mass index (BMI), and the presence of diabetes, hypertension, or dyslipidaemia.

Results: Fifty-four patients with NAFLD associated HCC were identified. Mean age was 64 years with 87% male. Fifteen percent (8/54) were not cirrhotic. 11%, 24% and 50% had a BMI of <25 kg/m2, 25-29 kg/m2 and ≥30 kg/m2 respectively. Fifty-nine percent were diabetic, 44% hypertensive and 26% hyperlipidaemic. Thirty-four percent of the patients had ≤1 of these risk factors. Non-cirrhotics had a significantly larger mean tumour diameter at diagnosis than cirrhotics (P=0.041). Multivariate analysis did not identify any other patient characteristics that predicted the size or number of HCC.

Conclusion: HCC can develop in NAFLD without cirrhosis. At diagnosis such tumours are larger than those in cirrhotics, conferring a poorer prognosis.

Keywords: Cryptogenic cirrhosis; Hepatocellular carcinoma; Metabolic syndrome; Non-alcoholic fatty liver disease; Screening.

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Figures

Figure 1
Figure 1
Body mass index at diagnosis of hepatocelullar carcinoma demonstrating that a large proportion of patients were overweight or obese (A) and prevalence of number of risk factors for hepatocelullar carcinoma - overweight or obesity, diabetes, hypertension and dyslipidaemia (B). Notably 34% of patients had less than 2 risk factors.
See this image and copyright information in PMC

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