代谢功能障碍相关的脂肪性肝病（MASLD）的患病率持续上升，使其成为慢性肝病的主要病因，也是肝脏相关死亡的主要原因。 MASLD 可进展为脂肪性肝炎（称为 MASH）、纤维化、肝硬化，并最终发展为癌症。 MASLD 与肝细胞癌 (HCC) 和肝外恶性肿瘤的风险增加相关，肝硬化和非肝硬化患者均可发生肝外恶性肿瘤，这强调了识别有发生 MASLD 相关恶性肿瘤风险的 MASLD 患者的重要性。然而，针对具有癌症风险的 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 MASH 相关肝硬化的个体每六个月接受一次 HCC 监测（例如通过超声和​​生物标志物）。迄今为止，尚未建立针对非肝硬化病例中 MASLD 相关恶性肿瘤的具体筛查方法。快速发展的组学技术，包括遗传学、代谢组学和蛋白质组学，显示出发现非侵入性标记物以满足这一未满足需求的巨大潜力。本综述概述了 MASLD 相关恶性肿瘤的发病率和死亡率、MASLD 患者 HCC 筛查、监测和诊断的当前策略，以及组学技术在发现用于预测和风险的非侵入性标记物方面不断发展的作用MASLD 相关 HCC 的分层。摘要。版权所有 © 2024。由 Elsevier Inc. 出版。

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. SUMMARY.Copyright © 2024. Published by Elsevier Inc.