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2025-07-25 10:15本頁(yè)面
【正文】 liver disease and subsequently increases HCC risk. ? ElSerag et al demonstrated that the incidence of HCC was doubled among patients with diabetes. Similar findings were reported recently in a Japanese cohort study. ? Those reports strongly suggest that insulin resistance precedes cirrhosis and HCC. Management ? Given the likely relations between metabolic syndrome and HCC risk, several strategies have been attempted in the management of NASH (Table 1). The most straightforward are interventions that lead to weight loss. Outes ? Outes in obese patients with HCC after surgery may also be worse. ? One Japanese study demonstrated no effect on overall survival or disease recurrence for patients undergoing an initial resection but a significantly worsened overall survival and disease recurrence was noted in obese patients who underwent repeat hepatectomy. ? Patients with hepatic steatosis may be at increased risk for tumor recurrence after resection. ? Finally, diabetics also may have an increased risk of HCC recurrence. Summary and Future Directions ? In the liver, inflammatory and angiogenic changes because of underlying insulin resistance and fatty liver disease likely will lead to an increase in the number of patients with HCC in the near future. ? Much work is needed to define more clearly the risks of developing HCC in individuals with underlying metabolic syndrome, the best methods for screening those at risk, and, ultimately, the best treatments targeting the underlying mechanisms of pathogenesis. Thank you！
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