| Background: Non-alcoholic steatohepatitis (NASH) was first proposed by Peters in the1970s．Ludwig divided NASH into primary and secondary in clinic．In recent years,with the improvement of people’s living condition and changes in diet，increasingincidence of obesity and diabetes，and the incidence of non-alcoholic fatty liver disease(NAFLD) also trends to rising．NAFLD has gradually become one of the three mainliver diseases which are harmful for human health. NASH as an intermediate stage ofNAFLD has attracted more and more concern．With the progression of NAFLD，theliver tissue appears ballooning degeneration，acinar spotty necrosis，and inflammationin/around the portal area．It suggests that simple fatty liver disease has progressed toNASH. When acinar zone III appears perisinusoidal fibrosis，which has extended to theportal area and came out focal or extensive bridging fibrosis，the NASH patients mayprogress varies degrees of liver fibrosis or cirrhosis，and even develops liver failure orhepatocellular carcinoma (HCC)．NAFLD/NASH may become another important riskfactor of primary hepatocellular carcinoma beyond HBV and HCV．Currently peoplehave reached a consensus that NASH can progress to hepatocellular carcinoma based oncirrhosis， while there is few paper reports that NASH can induce hepatocellularcarcinoma without cirrhosis． There is no clear conclusion between NASH andhepatocellular carcinoma．Aims：To prove that NASH is a risk factor for HCC through a comprehensive analysisof existing literatures．Methods："nonalcoholic steatohepatitis、fatty liver、liver cancer、NASH、hepatocellular carcinoma、NASH and HCC、HCC、liver neoplasmas、nonalcoholic steatohepatitis andhepatocellular carcinoma、hepatoma" as key words, we retrieved PubMed, Medline andOVID database, included and analyzed the clinical data of33articles published from1990to2013with416NASH related hepatocellular carcinoma patients. The data wereanalyzed by SPSS17.0. Chi square test was used to analyze the incidence ofhepatocellular carcinoma in NASH and in hepatitis B patients．Results：(1) In416NASH cases in this study,17.79%HCC progressed tohepatocellular carcinoma without liver cirrhosis while82.21%with cirrohsis, suggestedthat NASH has the possibility to develop HCC without cirrhosis;(2) Follow-up studyshowed a up to16.7%incidence of hepatocellular carcinoma in NASH patients, evenhigher than the incidence of hepatitis B (4.4%). The Chi square test had statisticalsignificance (p=0.000).(3) Diagnosed HCC patients based on NASH had the averageage of66.97, male patients accounted for59.43%, male to female patients ratio was1.46:1，suggested that NASH in elderly men were the high-risk population;(4)67.61%patients with HCC occurred in416patients based on NASH were with obesity,59.13%with diabetes mellitus,27.76%with hyperlipidemia,38.3%with hypertension,6.97%were not listed above, suggested that obesity and diabetes were the main risk factors;(5)Among3409HCC patients regardless of etiology in this research, the occurrence onthe basis of NASH was5.37%, was the third pathogenic factors behind the HBV andalcohol;(6) The majority of patients with HCC were found in routine examination,without any symptoms．Conclusions:NASH may be a risk factor for HCC．... |
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