Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Surveillance of Hepatocellular Carcinoma in Nonalcoholic Fatty Liver Disease

Version 1 : Received: 12 July 2020 / Approved: 14 July 2020 / Online: 14 July 2020 (13:55:16 CEST)

A peer-reviewed article of this Preprint also exists.

Sumida, Y.; Yoneda, M.; Seko, Y.; Ishiba, H.; Hara, T.; Toyoda, H.; Yasuda, S.; Kumada, T.; Hayashi, H.; Kobayashi, T.; Imajo, K.; Yoneda, M.; Tada, T.; Kawaguchi, T.; Eguchi, Y.; Oeda, S.; Takahashi, H.; Tomita, E.; Okanoue, T.; Nakajima, A.; Japan Study Group of NAFLD (JSG-NAFLD). Surveillance of Hepatocellular Carcinoma in Nonalcoholic Fatty Liver Disease. Diagnostics 2020, 10, 579. Sumida, Y.; Yoneda, M.; Seko, Y.; Ishiba, H.; Hara, T.; Toyoda, H.; Yasuda, S.; Kumada, T.; Hayashi, H.; Kobayashi, T.; Imajo, K.; Yoneda, M.; Tada, T.; Kawaguchi, T.; Eguchi, Y.; Oeda, S.; Takahashi, H.; Tomita, E.; Okanoue, T.; Nakajima, A.; Japan Study Group of NAFLD (JSG-NAFLD). Surveillance of Hepatocellular Carcinoma in Nonalcoholic Fatty Liver Disease. Diagnostics 2020, 10, 579.

Journal reference: Diagnostics 2020, 10, 579
DOI: 10.3390/diagnostics10080579

Abstract

Nonalcoholic fatty liver disease (NAFLD) is becoming the leading cause of hepatocellular carcinoma (HCC), liver-related mortality, and liver transplantation. There is reasonable epidemiological cohort data to recommend surveillance of patients with NAFLD based upon the incidence of HCC. The American Gastroenterology Association (AGA) expert review published in 2020 recommend that NAFLD patients with cirrhosis or advanced fibrosis estimated by non-invasive tests (NITs) should consider HCC surveillance. NITs include fibrosis-4 (FIB-4) index, the enhanced liver fibrosis (ELF) test, FibroScan, and MR elastography. The recommended surveillance modality is abdominal ultrasound (US) given that it is cost effective and noninvasive with good sensitivity. However, US is limited in obese patients and those with NAFLD. In NAFLD patients with a high likelihood of having an inadequate US or if US is attempted but inadequate, CT or MRI may be utilized. The GALAD score, consisting of age, gender, AFP, lens culinaris-agglutinin-reactive fraction of AFP (AFP-L3), and protein induced by vitamin K absence or antagonist-II (PIVKA-II), can help to identify high risk of incident HCC in NAFLD patients. Innovative parameters including Mac-2 binding protein glycated isomer , type IV collagen 7S, free apoptosis inhibitor of macrophage, combination of single nucleoside polymorphisms are expected to be established. Considering a large number of NAFLD population, optimal screening tests must meet several criteria including high sensitivity, cost effectiveness and availability.

Subject Areas

hepatic fibrosis; Mac-2 binding protein glycated isomer; apoptosis inhibitor of macrophage; patatin-like phospholipase domain-containing protein 3; α-fetoprotein; PIVKA-II

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