用于检测和预测与代谢功能障碍相关的脂肪性肝脏疾病相关的恶性肿瘤的诊断技术和OMICS技术
Diagnostics and omics technologies for the detection and prediction of metabolic dysfunction-associated steatotic liver disease-related malignancies
影响因子:11.90000
分区:医学1区 Top / 内分泌学与代谢1区
发表日期:2024 Dec
作者:
Tian Lan, Frank Tacke
摘要
代谢功能障碍相关的脂肪分裂肝病（MASLD）的患病率继续升高，使其成为慢性肝病的主要病因，也是肝相关死亡率的主要原因。 MASLD可以发展为脂肪性肝炎（称为MASH），纤维化，肝硬化和最终癌症。 MASLD与肝细胞癌（HCC）的风险增加以及肝外恶性肿瘤有关，这些恶性肿瘤可能在持续性和非核酸毒性患者中发展，这强调了鉴定具有与MASLD相关的恶性肿瘤患者识别MASLD患者的重要性。但是，针对患有癌症风险的MASLD患者的最佳筛查，诊断和风险分层策略仍在争论中。建议患有与MASH相关的肝硬化患者每六个月接受一次监视HCC（例如，超声和生物标志物）。迄今为止，尚未确定非肉毒相关病例中与MASLD相关的恶性肿瘤的特定筛查方法。快速发展的OMICS技术，包括遗传学，代谢组学和蛋白质组学，具有发现非侵入性标记以满足这种未满足需求的巨大潜力。这篇综述概述了与MASLD相关的恶性肿瘤的发病率和死亡率，HCC筛查的当前策略，MASLD患者的监视和诊断以及OMICS技术在发现非侵入性标记中的不断变化的作用，以预测与MASLD相关HCC的预测和风险分层。
Abstract
The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) continues to rise, making it the leading etiology of chronic liver diseases and a prime cause of liver-related mortality. MASLD can progress into steatohepatitis (termed MASH), fibrosis, cirrhosis, and ultimately cancer. MASLD is associated with increased risks of hepatocellular carcinoma (HCC) and also extrahepatic malignancies, which can develop in both cirrhotic and non-cirrhotic patients, emphasizing the importance of identifying patients with MASLD at risk of developing MASLD-associated malignancies. However, the optimal screening, diagnostic, and risk stratification strategies for patients with MASLD at risk of cancer are still under debate. Individuals with MASH-associated cirrhosis are recommended to undergo surveillance for HCC (e.g. by ultrasound and biomarkers) every six months. No specific screening approaches for MASLD-related malignancies in non-cirrhotic cases are established to date. The rapidly developing omics technologies, including genetics, metabolomics, and proteomics, show great potential for discovering non-invasive markers to fulfill this unmet need. This review provides an overview on the incidence and mortality of MASLD-associated malignancies, current strategies for HCC screening, surveillance and diagnosis in patients with MASLD, and the evolving role of omics technologies in the discovery of non-invasive markers for the prediction and risk stratification of MASLD-associated HCC.