Abstract
Nonalcoholic fatty liver disease (NAFLD) is easily the most common cause of chronic
liver disease in the United States (U.S.) as the hepatic manifestation of the metabolic
syndrome. Although only 5 to 20% of patients with NAFLD are generally considered to
meet criteria for nonalcoholic steatohepatitis (NASH), with its inherent risk for
progression to cirrhosis, this still represents an alarmingly large number of individuals.
The exponentially growing rates of hepatocellular carcinoma (HCC) in the U.S. may
be partially attributable to increased numbers of NASH cirrhotics, although recent
evidence has suggested that NAFLD may directly promote hepatic carcinogenesis independent
of cirrhosis. This review focuses on HCC in noncirrhotic NASH with an emphasis on
clinical presentation, pathogenesis, and implications for screening.
Keywords
Nonalcoholic fatty liver disease - nonalcoholic steatohepatitis - insulin resistance
- hepatocellular carcinoma
