본문 바로가기
KERD
논문KCI 등재

Development and prognosis of hepatocellular carcinoma in patients with diabetes

Takuma Nakatsuka|Ryosuke Tateishi
대한간학회 (The korean Association for the Study of the Liver)|2023.02|Clinical and Molecular Hepatology|제29권 제1호|pp. 51-64

0

조회

0

다운로드

3

인용

0

참고문헌

키워드

Diabetes mellitusHepatocellular carcinomaInsulin resistanceNon-alcoholic fatty liver diseaseHyperinsulinemia

초록

The incidence of diabetes mellitus and hepatocellular carcinoma (HCC) has been increasing worldwide during the last few decades, in the context of an increasing prevalence of obesity and non-alcoholic fatty liver disease (NAFLD). Epidemiologic studies have revealed that patients with diabetes have a 2- to 3-fold increased risk of developing HCC, independent of the severity and cause of the underlying liver disease. A bidirectional relationship exists between diabetes and liver disease: advanced liver disease promotes the onset of diabetes, and HCC is an important cause of death in patients with diabetes; conversely, diabetes is a risk factor for liver fibrosis progression and HCC development, and may worsen the long-term prognosis of patients with HCC. The existence of close interconnections among diabetes, obesity, and NAFLD causes insulin resistance-related hyperinsulinemia, increased oxidative stress, and chronic inflammation, which are assumed to be the underlying causes of hepatocarcinogenesis in patients with diabetes. No appropriate surveillance methods for HCC development in patients with diabetes have been established, and liver diseases, including HCC, are often overlooked as complications of diabetes. Although some antidiabetic drugs are expected to prevent HCC development, further research on the optimal use of antidiabetic drugs aimed at hepatoprotection is warranted. Given the increasing medical and socioeconomic impact of diabetes on HCC development, diabetologists and hepatologists need to work together to develop strategies to address this emerging health issue. This article reviews the current knowledge on the impact of diabetes on the development and progression of HCC.

Abstract

The incidence of diabetes mellitus and hepatocellular carcinoma (HCC) has been increasing worldwide during the last few decades, in the context of an increasing prevalence of obesity and non-alcoholic fatty liver disease (NAFLD). Epidemiologic studies have revealed that patients with diabetes have a 2- to 3-fold increased risk of developing HCC, independent of the severity and cause of the underlying liver disease. A bidirectional relationship exists between diabetes and liver disease: advanced liver disease promotes the onset of diabetes, and HCC is an important cause of death in patients with diabetes; conversely, diabetes is a risk factor for liver fibrosis progression and HCC development, and may worsen the long-term prognosis of patients with HCC. The existence of close interconnections among diabetes, obesity, and NAFLD causes insulin resistance-related hyperinsulinemia, increased oxidative stress, and chronic inflammation, which are assumed to be the underlying causes of hepatocarcinogenesis in patients with diabetes. No appropriate surveillance methods for HCC development in patients with diabetes have been established, and liver diseases, including HCC, are often overlooked as complications of diabetes. Although some antidiabetic drugs are expected to prevent HCC development, further research on the optimal use of antidiabetic drugs aimed at hepatoprotection is warranted. Given the increasing medical and socioeconomic impact of diabetes on HCC development, diabetologists and hepatologists need to work together to develop strategies to address this emerging health issue. This article reviews the current knowledge on the impact of diabetes on the development and progression of HCC.

참고문헌 (105)

  1. Sung H, "Global cancer statistics 2020 : GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries", CA Cancer J Clin, 71, pp.209~249 (2021)
  2. McGlynn KA, "Epidemiology of hepatocellular carcinoma", Hepatology, 73(Suppl 1), pp.4~13 (2021)
  3. El-Serag HB, "Epidemiology of viral hepatitis and hepatocellular carcinoma", Gastroenterology, 142, pp.1264~1273 (2012)
  4. Foerster F, "NAFLD-driven HCC : safety and efficacy of current and emerging treatment options", J Hepato, 76, pp.446~457 (2022)
  5. Shikata K, "Diabetes mellitus and cancer risk : review of the epidemiological evidence", Cancer Sci, 104, pp.9~14 (2013)
  6. Walker JJ, "Diabetes treatments and cancer risk : the importance of considering aspects of drug exposure", Lancet Diabetes Endocrinol, 1, pp.132~139 (2013)
  7. Mantovani A, "Type 2 diabetes mellitus and risk of hepatocellular carcinoma : spotlight on nonalcoholic fatty liver disease", Ann Transl Med, 5, pp.270~ (2017)
  8. Marengo A, "Liver cancer : connections with obesity, fatty liver, and cirrhosis", Annu Rev Med, 67, pp.103~117 (2016)
  9. El-Serag HB, "The role of diabetes in hepatocellular carcinoma : a case-control study among United States veterans", Am J Gastroenterol, 96, pp.2462~2467 (2001)
  10. Allaire M, "Type 2 diabetes-associated hepatocellular carcinoma: a molecular profile", Clin Liver Dis(Hoboken), 8, pp.53~58 (2016)
  11. Davila JA, "Diabetes increases the risk of hepatocellular carcinoma in the United States : a population based case control study", Gut, 54, pp.533~539 (2005)
  12. El-Serag HB, "The association between diabetes and hepatocellular carcinoma : a systematic review of epidemiologic evidence", Clin Gastroenterol Hepatol, 4, pp.369~380 (2006)
  13. Wang C, "Increased risk of hepatocellular carcinoma in patients with diabetes mellitus : a systematic review and meta-analysis of cohort studies", Int J Cancer, 130, pp.1639~1648 (2012)
  14. Yang WS, "The role of preexisting diabetes mellitus on hepatocellular carcinoma occurrence and prognosis : a meta-analysis of prospective cohort studies", PLoS One, 6, pp.e27326~ (2011)
  15. Váncsa S, "Diabetes mellitus increases the risk of hepatocellular carcinoma after direct-acting antiviral therapy: systematic review and meta-analysis", Front Med(Lausanne), 8, pp.744512~ (2021)
  16. Yang C, "Associations between diabetes mellitus and the risk of hepatocellular carcinoma in Asian individuals with hepatitis B and C infection : systematic review and a meta-analysis of cohort studies", Eur J Cancer Prev, 31, pp.107~116 (2022)
  17. Dyal HK, "Diabetes mellitus increases risk of hepatocellular carcinoma in chronic hepatitis C virus patients : a systematic review", Dig Dis Sci, 61, pp.636~645 (2016)
  18. Yoo JJ, "Glucose variability and risk of hepatocellular carcinoma in patients with diabetes : a nationwide population-based study", Cancer Epidemiol Biomarkers Prev, 30, pp.974~981 (2021)
  19. El-Serag HB, "Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma", Gastroenterology, 126, pp.460~468 (2004)
  20. Simon TG, "Diabetes, metabolic comorbidities, and risk of hepatocellular carcinoma : results from two prospective cohort studies", Hepatology, 67, pp.1797~1806 (2018)
  21. Wang YG, "Diabetes mellitus and poorer prognosis in hepatocellular carcinoma : a systematic review and meta-analysis", PLoS One, 9, pp.e95485~ (2014)
  22. Wang WM, "Prognostic role of diabetes mellitus in hepatocellular carcinoma patients after curative treatments : a meta-analysis", Hepatobiliary Pancreat Dis Int, 10, pp.346~355 (2011)
  23. Tateishi R, "A nationwide survey on non-B, non-C hepatocellular carcinoma in Japan : 2011-2015 update", J Gastroenterol, 54, pp.367~376 (2019)
  24. Lee WG, "Prevalence of diabetes in liver cirrhosis : a systematic review and metaanalysis", Diabetes Metab Res Rev, 35, pp.e3157~ (2019)
  25. Harrison SA, "Liver disease in patients with diabetes mellitus", J Clin Gastroenterol, 40, pp.68~76 (2006)
  26. Younossi ZM, "The global epidemiology of NAFLD and NASH in patients with type 2 diabetes : a systematic review and meta-analysis", J Hepatol, 71, pp.793~801 (2019)
  27. Nakatsuka T, "Changing clinical management of NAFLD in Asia", Liver Int, 42, pp.1955~1968 (2022)
  28. Poonawala A, "Prevalence of obesity and diabetes in patients with cryptogenic cirrhosis : a case-control study", Hepatology, 32(4 Pt 1), pp.689~692 (2000)
  29. Armstrong MJ, "Extrahepatic complications of nonalcoholic fatty liver disease", Hepatology, 59, pp.1174~1197 (2014)
  30. Angulo P, "Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis", Hepatology, 30, pp.1356~1362 (1999)
  31. Zoppini G, "Mortality from chronic liver diseases in diabetes", Am J Gastroenterol, 109, pp.1020~1025 (2014)
  32. Adams LA, "The histological course of nonalcoholic fatty liver disease : a longitudinal study of 103 patients with sequential liver biopsies", J Hepatol, 42, pp.132~138 (2005)
  33. Gentile S, "Incidence of altered glucose tolerance in liver cirrhosis", Diabetes Res Clin Pract, 22, pp.37~44 (1993)
  34. Holstein A, "Clinical implications of hepatogenous diabetes in liver cirrhosis", J Gastroenterol Hepatol, 17, pp.677~681 (2002)
  35. Saeedi P, "Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045 : results from the international diabetes federation diabetes atlas, 9th edition", Diabetes Res Clin Prac, 157, pp.107843~ (2019)
  36. Arnold M, "Global burden of cancer attributable to high body-mass index in 2012 : a population-based study", Lancet Oncol, 16, pp.36~46 (2015)
  37. Tsilidis KK, "Type 2 diabetes and cancer : umbrella review of meta-analyses of observational studies", BMJ, 350, pp.g7607~ (2015)
  38. Huang Y, "Prediabetes and the risk of cancer : a meta-analysis", Diabetologia, 57, pp.2261~2269 (2014)
  39. Lawson DH, "Diabetes mellitus and primary hepatocellular carcinoma", Q J Med, 61, pp.945~955 (1986)
  40. Adami HO, "Excess risk of primary liver cancer in patients with diabetes mellitus", J Natl Cancer Inst, 88, pp.1472~1477 (1996)
  41. Wideroff L, "Cancer incidence in a population-based cohort of patients hospitalized with diabetes mellitus in Denmark", J Natl Cancer Inst, 89, pp.1360~1365 (1997)
  42. Coughlin SS, "Diabetes mellitus as a predictor of cancer mortality in a large cohort of US adults", Am J Epidemiol, 159, pp.1160~1167 (2004)
  43. Johnson JA, "Time-varying incidence of cancer after the onset of type 2 diabetes : evidence of potential detection bias", Diabetologia, 54, pp.2263~2271 (2011)
  44. Lai SW, "Risk of hepatocellular carcinoma in diabetic patients and risk reduction associated with anti-diabetic therapy : a population-based cohort study", Am J Gastroenterol, 107, pp.46~52 (2012)
  45. Schlesinger S, "Diabetes mellitus, insulin treatment, diabetes duration, and risk of biliary tract cancer and hepatocellular carcinoma in a European cohort", Ann Oncol, 24, pp.2449~2455 (2013)
  46. Koh WP, "Diabetes mellitus and risk of hepatocellular carcinoma : findings from the Singapore Chinese health study", Br J Cancer, 108, pp.1182~1188 (2013)
  47. Setiawan VW, "Diabetes and racial", ethnic differences in hepatocellular carcinoma risk : the multiethnic cohort, 2014, pp.106, dju326~
  48. Inoue M, "Diabetes mellitus and the risk of cancer : results from a largescale population-based cohort study in Japan", Arch Intern Med, 166, pp.1871~1877 (2006)
  49. Lai MS, "Type 2 diabetes and hepatocellular carcinoma : a cohort study in high prevalence area of hepatitis virus infection", Hepatology, 43, pp.1295~1302 (2006)
  50. Atchison EA, "Risk of cancer in a large cohort of U. S. veterans with diabetes", Int J Cancer, 128, pp.635~643 (2011)
  51. Wang P, "Diabetes mellitus and risk of hepatocellular carcinoma : a systematic review and meta-analysis", Diabetes Metab Res Rev, 28, pp.109~122 (2012)
  52. Chen J, "Effect of type 2 diabetes mellitus on the risk for hepatocellular carcinoma in chronic liver diseases : a meta-analysis of cohort studies", Eur J Cancer Prev, 24, pp.89~99 (2015)
  53. Kanwal F, "Effect of metabolic traits on the risk of cirrhosis and hepatocellular cancer in nonalcoholic fatty liver disease", Hepatology, 71, pp.808~819 (2020)
  54. Tan Y, "Type 2 diabetes mellitus increases the risk of hepatocellular carcinoma in subjects with chronic hepatitis B virus infection : a meta-analysis and systematic review", Cancer Manag Res, 11, pp.705~713 (2019)
  55. Dyal HK, "Concurrent obesity, diabetes, and steatosis increase risk of advanced fibrosis among HCV patients : a systematic review", Dig Dis Sci, 60, pp.2813~2824 (2015)
  56. Arase Y, "Effect of type 2 diabetes on risk for malignancies includes hepatocellular carcinoma in chronic hepatitis C", Hepatology, 57, pp.964~973 (2013)
  57. Kasuga M, "Report of the Japan Diabetes Society", Japanese Cancer Association Joint Committee on Diabetes and Cancer, 2013, pp.104, 965~976
  58. Kudo Y, "Altered composition of fatty acids exacerbates hepatotumorigenesis during activation of the phosphatidylinositol 3-kinase pathway", J Hepatol, 55, pp.1400~1408 (2011)
  59. Nakatsuka T, "Impact of histone demethylase KDM3A-dependent AP-1 transactivity on hepatotumorigenesis induced by PI3K activation", Oncogene, 36, pp.6262~6271 (2017)
  60. Pollak M, "The insulin and insulin-like growth factor receptor family in neoplasia : an update", Nat Rev Cancer, 12, pp.159~169 (2012)
  61. Park EJ, "Dietary and genetic obesity promote liver inflammation and tumorigenesis by enhancing IL-6 and TNF expression", Cell, 140, pp.197~208 (2010)
  62. Yoshimoto S, "Obesity-induced gut microbial metabolite promotes liver cancer through senescence secretome", Nature, 499, pp.97~101 (2013)
  63. Shintani Y, "Hepatitis C virus infection and diabetes : direct involvement of the virus in the development of insulin resistance", Gastroenterology, 126, pp.840~848 (2004)
  64. Sheikh MY, "Hepatitis C virus infection : molecular pathways to metabolic syndrome", Hepatology, 47, pp.2127~2133 (2008)
  65. Wang CC, "Hepatitis B virus infection and metabolic syndrome : fact or fiction?", J Gastroenterol Hepatol, 30, pp.14~20 (2015)
  66. Rao Kondapally Seshasai S, "Diabetes mellitus, fasting glucose, and risk of cause-specific death", N Engl J Med, 364, pp.829~841 (2011)
  67. Nakamura J, "Causes of death in Japanese patients with diabetes based on the results of a survey of 45, 708 cases during 2001-2010 : report of the committee on causes of death in diabetes mellitus", J Diabetes Investig, 8, pp.397~410 (2017)
  68. Bragg F, "Association between diabetes and cause-specific mortality in rural and urban areas of China", JAMA, 317, pp.280~289 (2017)
  69. Liu G, "Type 2 diabetes mellitus worsens the prognosis of intermediate-stage hepatocellular carcinoma after transarterial chemoembolization", Diabetes Res Clin Pract, 169, pp.108375~ (2020)
  70. Ho SY, "Differential survival impact of diabetes mellitus on hepatocellular carcinoma : role of staging determinants", Dig Dis Sci, 65, pp.3389~3402 (2020)
  71. Nagaoki Y, "Increasing incidence of non-HBV-and non-HCV-related hepatocellular carcinoma : single-institution 20-year study", BMC Gastroenterol, 21, pp.306~ (2021)
  72. Finn RS, "Evolution of systemic therapy for hepatocellular carcinoma", Hepatology, 73(Suppl 1), pp.150~157 (2021)
  73. Marrero JA, "Diagnosis, staging, and management of hepatocellular carcinoma : 2018 practice guidance by the American Association for the Study of Liver Diseases", Hepatology, 68, pp.723~750 (2018)
  74. European Association for the Study of the Liver, "EASL clinical practice guidelines : management of hepatocellular carcinoma", J Hepatol, 69, pp.182~236 (2018)
  75. Omata M, "Asia-pacific clinical practice guidelines on the management of hepatocellular carcinoma : a 2017 update", Hepatol Int, 11, pp.317~370 (2017)
  76. Tateishi R, "Clinical characteristics, treatment, and prognosis of non-B, non-C hepatocellular carcinoma : a large retrospective multicenter cohort study", J Gastroenterol, 50, pp.350~360 (2015)
  77. Linda L. Wong, "Pitfalls in surveillance for hepatocellular carcinoma: How successful is it in the real world?", Clinical and Molecular Hepatology, 23(3), pp.239~248 (2017), 대한간학회[DOI]
  78. Si WK, "Predictors of increased risk of hepatocellular carcinoma in patients with type 2 diabetes", PLoS One, 11, pp.e0158066~ (2016)
  79. Li TC, "Risk score system for the prediction of hepatocellular carcinoma in patients with type 2 diabetes : Taiwan diabetes study", Semin Oncol, 45, pp.264~274 (2018)
  80. Rau HH, "Development of a web-based liver cancer prediction model for type II diabetes patients by using an artificial neural network", Comput Methods Programs Biomed, 125, pp.58~65 (2016)
  81. Grecian SM, "Non-invasive risk scores do not reliably identify future cirrhosis or hepatocellular carcinoma in type 2 diabetes : the edinburgh type 2 diabetes study", Liver Int, 40, pp.2252~2262 (2020)
  82. Tateishi R, "Hepatocellular carcinoma development in diabetic patients : a nationwide survey in Japan", J Gastroenterol, 56, pp.261~273 (2021)
  83. Luo X, "Type 2 diabetes prevention diet and hepatocellular carcinoma risk in US men and women", Am J Gastroenterol, 114, pp.1870~1877 (2019)
  84. Plaz Torres MC, "Diabetes medications and risk of HCC", Hepatology, 76, pp.1880~1897 (2022)
  85. Kyung-Soo Kim, "Beneficial effect of anti-diabetic drugs for nonalcoholic fatty liver disease", Clinical and Molecular Hepatology, 26(4), pp.430~443 (2020), 대한간학회[DOI]
  86. Evans JM, "Metformin and reduced risk of cancer in diabetic patients", BMJ, 330, pp.1304~1305 (2005)
  87. Home PD, "Experience of malignancies with oral glucose-lowering drugs in the randomised controlled ADOPT(a diabetes outcome progression trial)and RECORD(rosiglitazone evaluated for cardiovascular outcomes and regulation of glycaemia in diabetes)clinical trials", Diabetologia, 53, pp.1838~1845 (2010)
  88. Zhang ZJ, "Metformin for liver cancer prevention in patients with type 2 diabetes : a systematic review and meta-analysis", J Clin Endocrinol Metab, 97, pp.2347~2353 (2012)
  89. Zhang H, "Metformin and reduced risk of hepatocellular carcinoma in diabetic patients : a meta-analysis", Scand J Gastroenterol, 48, pp.78~87 (2013)
  90. Singh S, "Antidiabetic medications and the risk of hepatocellular cancer : a systematic review and meta-analysis", Am J Gastroenterol, 108, pp.881~891 (2013)
  91. Ma S, "Meta-analysis of studies using metformin as a reducer for liver cancer risk in diabetic patients", Medicine(Baltimore), 96, pp.e6888~ (2017)
  92. Li Q, "Impact of metformin use on risk and mortality of hepatocellular carcinoma in diabetes mellitus", Clin Res Hepatol Gastroenterol, 46, pp.101781~ (2022)
  93. Cunha V, "Metformin in the prevention of hepatocellular carcinoma in diabetic patients : a systematic review", Ann Hepatol, 19, pp.232~237 (2020)
  94. Zhou YY, "Systematic review with network meta-analysis : antidiabetic medication and risk of hepatocellular carcinoma", Sci Rep, 6, pp.33743~ (2016)
  95. Zhou J, "Meta-analysis : the efficacy of metformin and other anti-hyperglycemic agents in prolonging the survival of hepatocellular carcinoma patients with type 2 diabetes", Ann Hepatol, 19, pp.320~328 (2020)
  96. Bosetti C, "Insulin and other antidiabetic drugs and hepatocellular carcinoma risk : a nested case-control study based on Italian healthcare utilization databases", Pharmacoepidemiol Drug Saf, 24, pp.771~778 (2015)
  97. Aithal GP, "Randomized, placebo-controlled trial of pioglitazone in nondiabetic subjects with nonalcoholic steatohepatitis", Gastroenterology, 135, pp.1176~1184 (2008)
  98. Arvind A, "Thiazolidinediones, alpha-glucosidase inhibitors, meglitinides, sulfonylureas, and hepatocellular carcinoma risk : a meta-analysis", Metabolism, 120, pp.154780~ (2021)
  99. Lee JY, "Incident hepatocellular carcinoma risk in patients treated with a sulfonylurea : a nationwide, nested, case-control study", Sci Rep, 9, pp.8532~ (2019)
  100. Lee JY, "Comparison of hepatocellular carcinoma risk between patients treated with glimepiride and gliclazide", Diabetes Metab, 45, pp.83~85 (2019)
  101. Chang CH, "Oral insulin secretagogues, insulin, and cancer risk in type 2 diabetes mellitus", J Clin Endocrinol Metab, 97, pp.E1170~E1175 (2012)
  102. Nishina S, "Dipeptidyl peptidase 4 inhibitors reduce hepatocellular carcinoma by activating lymphocyte chemotaxis in mice", Cell Mol Gastroenterol Hepatol, 7, pp.115~134 (2018)
  103. Armstrong MJ, "Liraglutide safety and efficacy in patients with nonalcoholic steatohepatitis(LEAN) : a multicentre, doubleblind, randomised, placebo-controlled phase 2 study", Lancet, 387, pp.679~690 (2016)
  104. Newsome PN, "A placebo-controlled trial of subcutaneous semaglutide in nonalcoholic steatohepatitis", N Engl J Med, 384, pp.1113~1124 (2021)
  105. Shibuya T, "Luseogliflozin improves liver fat deposition compared to metformin in type 2 diabetes patients with non-alcoholic fatty liver disease : a prospective randomized controlled pilot study", Diabetes Obes Metab, 20, pp.438~442 (2018)

관련 논문AI추천

Diabetes and Risk of Hepatocellular Carcinoma in Cirrhosis Patients with Nonalcoholic Fatty Liver DiseaseHuang Daniel Q., Lin Ting-Yi, Noureddin Mazen, Teng Pai-Chi, Yang Ju Dong거트앤리버 소화기연관학회협의회 · Gut and Liver2023 · 제17권 제1호Impact of diabetes, obesity, and dyslipidemia on the risk of hepatocellular carcinoma in patients with chronic liver diseasesBaek Gyu Jun, Hwang Sik Shin, Sang-Wook Yi대한간학회 · Clinical and Molecular Hepatology2022 · 제28권 제4호Preventive strategy for nonalcoholic fatty liver disease-related hepatocellular carcinomaBo Hyun Kim, Joong-Won Park, Yuri Cho대한간학회 · Clinical and Molecular Hepatology2023 · 제29권 제2호Comparisons between non-alcoholic steatohepatitis and alcohol-related hepatocellular carcinomaBoon-Bee George Goh, Chee-Kiat Tan, Jia-Wen Kam, Pik-Eu Chang, Rahul Kumar대한간학회 · Clinical and Molecular Hepatology2020 · 제26권 제2호Metabolic disease as a risk of hepatocellular carcinomaNaoshi Nishida대한간학회 · Clinical and Molecular Hepatology2021 · 제27권 제1호Global prevalence of metabolic dysfunction-associated fatty liver disease-related hepatocellular carcinoma: A systematic review and meta-analysisAlessandro Vitale, Anjiya Shaikh, Beom Kyung Kim, Cameron Gofton, George Cholankeril, Gianluca Svegliati-Baroni, Guy D. Eslick, Harry Crane, Jacob George, Jian-Hong Zhong, Mark Cheah, Mi Na Kim, Sang Hoon Ahn, Simone I Strasser대한간학회 · Clinical and Molecular Hepatology2024 · 제30권 제3호

이 간행물의 다른 논문 (46건)

Subclinical versus advanced forms of alcohol-related liver disease: Need for early detectionLuma Melo, David Martí-Aguado, Ramón Bataller, Concepción Gómez-Medinapp. 1-15PrefaceYoon Jun Kimpp. 2-2PrefaceSeung Up Kimpp. 3-3Non-alcoholic fatty liver disease: Definition and subtypesSeul Ki Han, 김문영, 백순구pp. 5-16Management of refractory ascitesFlorence Wongpp. 16-32
원문 보기