Global prevalence of metabolic dysfunction-associated fatty liver disease-related hepatocellular carcinoma: A systematic review and meta-analysis
3
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background/Aims: The global proportion of hepatocellular carcinoma (HCC) attributable to metabolic dysfunction- associated fatty liver disease (MAFLD) is unclear. The MAFLD diagnostic criteria allows objective diagnosis in the presence of steatosis plus defined markers of metabolic dysfunction, irrespective of concurrent liver disease. We aimed to determine the total global prevalence of MAFLD in HCC cohorts (total-MAFLD), including the proportion with MAFLD as their sole liver disease (single-MAFLD), and the proportion of those with concurrent liver disease where MAFLD was a contributary factor (mixed-MAFLD). Methods: This systematic review and meta-analysis included studies systematically ascertaining MAFLD in HCC cohorts, defined using international expert panel criteria including ethnicity-specific BMI cut-offs. A comparison of clinical and tumour characteristics was performed between single-MAFLD, mixed-MAFLD, and non-MAFLD HCC. Results: 22 studies (56,565 individuals with HCC) were included. Total and single-MAFLD HCC prevalence was 48.7% (95% confidence interval [CI] 34.5–63.0%) and 12.4% (95% CI 8.3–17.3%), respectively. In HCC due to chronic hepatitis B, C, and alcohol-related liver disease, mixed-MAFLD prevalence was 40.0% (95% CI 30.2– 50.3%), 54.1% (95% CI 40.4–67.6%) and 64.3% (95% CI 52.7–75.0%), respectively. Mixed-MAFLD HCC had significantly higher likelihood of cirrhosis and lower likelihood of metastatic spread compared to single-MAFLD HCC, and a higher platelet count and lower likelihood of macrovascular invasion compared to non-MAFLD HCC. Conclusions: MAFLD is common as a sole aetiology, but more so as a co-factor in mixed-aetiology HCC, supporting the use of positive diagnostic criteria.
Abstract
Background/Aims: The global proportion of hepatocellular carcinoma (HCC) attributable to metabolic dysfunction- associated fatty liver disease (MAFLD) is unclear. The MAFLD diagnostic criteria allows objective diagnosis in the presence of steatosis plus defined markers of metabolic dysfunction, irrespective of concurrent liver disease. We aimed to determine the total global prevalence of MAFLD in HCC cohorts (total-MAFLD), including the proportion with MAFLD as their sole liver disease (single-MAFLD), and the proportion of those with concurrent liver disease where MAFLD was a contributary factor (mixed-MAFLD). Methods: This systematic review and meta-analysis included studies systematically ascertaining MAFLD in HCC cohorts, defined using international expert panel criteria including ethnicity-specific BMI cut-offs. A comparison of clinical and tumour characteristics was performed between single-MAFLD, mixed-MAFLD, and non-MAFLD HCC. Results: 22 studies (56,565 individuals with HCC) were included. Total and single-MAFLD HCC prevalence was 48.7% (95% confidence interval [CI] 34.5–63.0%) and 12.4% (95% CI 8.3–17.3%), respectively. In HCC due to chronic hepatitis B, C, and alcohol-related liver disease, mixed-MAFLD prevalence was 40.0% (95% CI 30.2– 50.3%), 54.1% (95% CI 40.4–67.6%) and 64.3% (95% CI 52.7–75.0%), respectively. Mixed-MAFLD HCC had significantly higher likelihood of cirrhosis and lower likelihood of metastatic spread compared to single-MAFLD HCC, and a higher platelet count and lower likelihood of macrovascular invasion compared to non-MAFLD HCC. Conclusions: MAFLD is common as a sole aetiology, but more so as a co-factor in mixed-aetiology HCC, supporting the use of positive diagnostic criteria.
참고문헌 (50)
- Rumgay H, "Global burden of primary liver cancer in 2020 and predictions to 2040", J Hepatol, 77, pp.1598~1606 (2022)
- Petrick JL, "The changing epidemiology of primary liver cancer", Curr Epidemiol Rep, 6, pp.104~111 (2019)
- Eslam M, "A new definition for metabolic dysfunction-associated fatty liver disease : An international expert consensus statement", J Hepatol, 73, pp.202~209 (2020)
- Eslam M, "MAFLD : A consensus-driven proposed nomenclature for metabolic associated fatty liver disease", Gastroenterology, 158, pp.1999~2014 (2020)
- Kawaguchi T, "MAFLD enhances clinical practice for liver disease in the Asia-Pacific region", Clin Mol Hepatol, 28, pp.150~163 (2022)
- Huang DQ, "Global epidemiology of NAFLD-related HCC : trends, predictions, risk factors and prevention", Nat Rev Gastroenterol Hepatol, 18, pp.223~238 (2021)
- Tan DJH, "Clinical characteristics, surveillance, treatment allocation, and outcomes of non-alcoholic fatty liver disease-related hepatocellular carcinoma : a systematic review and meta-analysis", Lancet Oncol, 23, pp.521~530 (2022)
- Dudek M, "Auto-aggressive CXCR6+ CD8 T cells cause liver immune pathology in NASH", Nature, 592, pp.444~449 (2021)
- Pfister D, "NASH limits anti-tumour surveillance in immunotherapy-treated HCC", Nature, 592, pp.450~456 (2021)
- Rimini M, "Atezolizumab plus bevacizumab versus lenvatinib or sorafenib in non-viral unresectable hepatocellular carcinoma : an international propensity score matching analysis", ESMO Open, 7, pp.100591~ (2022)
- Shimose S, "The beneficial impact of metabolic dysfunction-associated fatty liver disease on lenvatinib treatment in patients with non-viral hepatocellular carcinoma", Hepatol Res, 53, pp.104~115 (2023)
- Crane H, "MAFLD : an optimal framework for understanding liver cancer phenotypes", J Gastroenterol, 58, pp.947~964 (2023)
- Gao F, "Metabolic dysfunction-associated fatty liver disease and hepatocellular carcinoma : present and future", Hepatobiliary Surg Nutr, 12, pp.945~948 (2023)
- Llovet JM, "Nonalcoholic steatohepatitisrelated hepatocellular carcinoma : pathogenesis and treatment", Nat Rev Gastroenterol Hepatol, 20, pp.487~503 (2023)
- Moher D, "Preferred reporting items for systematic reviews and metaanalyses : the PRISMA statement", BMJ, 339, pp.b2535~ (2009)
- Freeman MF, "Transformations related to the angular and the square root", The Annals of Mathematical Statistics, 21, pp.607~611 (1950)
- DerSimonian R, "Meta-analysis in clinical trials", Control Clin Trials, 7, pp.177~188 (1986)
- Wan X, "Estimating the sample mean and standard deviation from the sample size, median, range and", or interquartile range, 2014, pp.14, 135~
- Duval S, "A nonparametric"Trim and Fill"method of accounting for publication bias in meta-analysis", J Am Stat Assoc, 95, pp.89~98 (2000)
- Hoy D, "Assessing risk of bias in prevalence studies : modification of an existing tool and evidence of interrater agreement", J Clin Epidemiol, 65, pp.934~939 (2012)
- Yun B, "Prognostic impact of MAFLD following surgical resection of hepatitis B virus-related hepatocellular carcinoma : A nationwide cohort study", Cancers(Basel), 14, pp.5002~ (2022)
- Reggidori N, "Lack of substantial improvements in the landscape of alcohol-related hepatocellular carcinoma in the last 15 years : The need to improve cancer prevention and surveillance", Dig Liver Dis, 55(Suppl 1), pp.S16~S17 (2023)
- Conci S, "Hepatectomy for Metabolic Associated Fatty Liver Disease(MAFLD)related HCC : Propensity case-matched analysis with viral-and alcohol-related HCC", Eur J Surg Oncol, 48, pp.103~112 (2022)
- Kim MN, "Metabolic dysfunction-associated fatty liver disease subgroups and risk of hepatocellular carcinoma and mortality in patients with chronic viral hepatitis", J Hepatol, 77, pp.S100~ (2022)
- Yu MW, "Metabolicassociated fatty liver disease, hepatitis B surface antigen seroclearance, and long-term risk of hepatocellular carcinoma in chronic hepatitis B", Cancers(Basel), 14, pp.6012~ (2022)
- Feng G, "Recompensation in cirrhosis : unravelling the evolving natural history of nonalcoholic fatty liver disease", Nat Rev Gastroenterol Hepatol, 21, pp.46~56 (2024)
- van der Spek DPC, "Time-trends in disease characteristics and comorbidities in patients with chronic hepatitis B in the period 1980-2020", Eur J Intern Med, 107, pp.86~92 (2023)
- Eslam M, "Metabolic(dysfunction)-associated fatty liver disease in individuals of normal weight", Nat Rev Gastroenterol Hepatol, 19, pp.638~651 (2022)
- Ye Q, "Global prevalence, incidence, and outcomes of non-obese or lean non-alcoholic fatty liver disease : a systematic review and meta-analysis", Lancet Gastroenterol Hepatol, 5, pp.739~752 (2020)
- Park JW, "Global patterns of hepatocellular carcinoma management from diagnosis to death : the BRIDGE Study", Liver Int, 35, pp.2155~2166 (2015)
- Patkar S, "Performance of Hong Kong Liver Cancer staging system in patients of hepatocellular carcinoma treated with surgical resection : An Indian validation study", J Surg Oncol, 120, pp.1119~1125 (2019)
- Younossi ZM, "Association of nonalcoholic fatty liver disease(NAFLD)with hepatocellular carcinoma(HCC)in the United States from 2004 to 2009", Hepatology, 62, pp.1723~1730 (2015)
- Haldar D, "Outcomes of liver transplantation for non-alcoholic steatohepatitis : A European Liver Transplant Registry study", J Hepatol, 71, pp.313~322 (2019)
- Younossi ZM, "Nonalcoholic steatohepatitis is the most rapidly increasing indication for liver transplantation in the United States", Clin Gastroenterol Hepatol, 19, pp.580~589 (2021)
- Alexander M, "Real-world data reveal a diagnostic gap in non-alcoholic fatty liver disease", BMC Med, 16, pp.130~ (2018)
- Staufer K, "Ethyl glucuronide in hair detects a high rate of harmful alcohol consumption in presumed nonalcoholic fatty liver disease", J Hepatol, 77, pp.918~930 (2022)
- van Kleef LA, "Metabolic dysfunction-associated fatty liver disease improves detection of high liver stiffness : The Rotterdam Study", Hepatology, 75, pp.419~429 (2022)
- Tsutsumi T, "MAFLD better predicts the progression of atherosclerotic cardiovascular risk than NAFLD : Generalized estimating equation approach", Hepatol Res, 51, pp.1115~1128 (2021)
- Fukunaga S, "Lean", normal-weight metabolic dysfunctionassociated fatty liver disease is a risk factor for reflux esophagitis, 2022, pp.52, 699~711
- Tsutsumi T, "MAFLD associated with COPD via systemic inflammation independent of aging and smoking in men", Diabetol Metab Syndr, 14, pp.115~ (2022)
- Fukunaga S, "Impact of non-obese metabolic dysfunctionassociated fatty liver disease on risk factors for the recurrence of esophageal squamous cell carcinoma treated with endoscopic submucosal dissection : A multicenter study", Hepatol Res, 54, pp.201~212 (2024)
- Nakane T, "Impact of metabolic dysfunction-associated fatty liver disease on the incidence of Helicobacter pylori-negative gastric cancer", Hepatol Res, 54, pp.540~550 (2024)
- Chan KE, "Global prevalence and clinical characteristics of metabolicassociated fatty liver disease : A meta-analysis and systematic review of 10 739 607 Individuals", J Clin Endocrinol Metab, 107, pp.2691~2700 (2022)
- Golabi P, "Burden of non-alcoholic fatty liver disease in Asia, the Middle East and North Africa : Data from Global Burden of Disease 2009-2019", J Hepatol, 75, pp.795~809 (2021)
- Zhang CH, "Changing epidemiology of hepatocellular carcinoma in Asia", Liver Int, 42, pp.2029~2041 (2022)
- Enomoto H, "The transition in the etiologies of hepatocellular carcinoma-complicated liver cirrhosis in a nationwide survey of Japan", J Gastroenterol, 56, pp.158~167 (2021)
- Kumar R, "Comparisons between non-alcoholic steatohepatitis and alcohol-related hepatocellular carcinoma", Clin Mol Hepatol, 26, pp.196~208 (2020)
- Tokushige K, "Prospective study of hepatocellular carcinoma in nonalcoholic steatohepatitis in comparison with hepatocellular carcinoma caused by chronic hepatitis C", J Gastroenterol, 45, pp.960~967 (2010)
- Piscaglia F, "Clinical patterns of hepatocellular carcinoma in nonalcoholic fatty liver disease : A multicenter prospective study", Hepatology, 63, pp.827~838 (2016)
- Chung GE, "Lean or diabetic subtypes predict increased all-cause and disease-specific mortality in metabolic-associated fatty liver disease", BMC Med, 21, pp.4~ (2023)