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Časopis Internal medicine – Článok Non-alcoholic fatty liver disease and hepatocellular carcinoma: overview and analysis of the Nitra cohort

Internal medicine

Peer - Reviewed Postgraduate Medical Journal.
Period 11x per year (july - august double issue)
1335-8359
The journal is indexed in the Slovak National Bibliography, Bibliographiia Medica Slovaca (BMS) and listed to citation database CiBaMed. All articles are reviewed. The publisher does not bear any responsibility for data and opinions of particular authors of the articles or advertisements. The articles on grey pages are company promotions or non reviewed information, an author is responsible for the content. Any reproduction of the content is allowed only with direct consent of the editorial office.
Predplatné
Internal medicine
Internal medicine
Peer - Reviewed Postgraduate Medical Journal.
Period 11x per year (july - august double issue)
Predplatné
Téma: Original works

Non-alcoholic fatty liver disease and hepatocellular carcinoma: overview and analysis of the Nitra cohort

Marek Rác, Tomáš Koller, Andrej Klepanec, Ivan Vaňo, Marián Streško, Marián Bakoš, Peter Jarčuška, Ľubomír Skladaný

Introduction: Obesity and metabolic syndrome are known risk factors for the non-alcoholic fatty liver disease (NAFLD) origination.
NAFLD presents a liver manifestation of metabolic syndrome. NAFLD is a multifactorial disease and leads to progression
and development of hepatic and extrahepatic complications. Hepatocellular carcinoma (HCC) is the most common primary
hepatocellular carcinoma and actually the fifth most common carcinoma. HCC has the fastest growing incidence among solid
tumours and presents one of the most lethal carcinomas with high fatality. It originates mainly in the terrain of chronic inflammatory
liver disease, which led to cirrhosis. HCC originating in the non-cirrhotic liver has its aetiological specifics, out of them resulting
cytogenetic, histopathological and clinical differences.
The aim of the work: To identify and find out: 1) the share of NAFLD aetiology in the HCC cohort; 2) the proportion of NAFLD
HCC in the non-cirrhotic terrain; 3) differences between subgroups NAFLD HCC versus other aetiology; 4) differences between
non-cirrhotic HCC and HCC found in the cirrhosis terrain.
Methods and patients: Retrospective analysis of patients with HCC, a cohort of consecutively diagnosed patients with HCC from
the hepatological centre in Faculty Hospital Nitra, time interval 1/2012 – 8/2016. Inclusive criteria: HCC diagnosis. Exclusive criteria:
lack of data. Recorded variables: demographic data, aetiology of liver diseases, presence or absence of liver cirrhosis (USG,
CT, MRI, EGDS) or histology.
Results: We analysed 103 patients (n=103). Selected variables of the cohort: age = 68 (14 – 86), the share of women = 19 %; aetiology
of liver disease = ALD – 57 %, NAFLD – 42 %, Hep-B + Hep-C – 7 %, AIH – 6 %. 19 patients (20 %) from our cohort did
not have proved liver cirrhosis; 71 % of them had NAFLD aetiology of HCC; 53 % created women (vs 12 % in Ci-HCC cohort,
p = 0.0001). When comparing NAFLD-HCC (n = 40) with non-NAFLD-HCC (n = 55) we detected differences: age: 68.6 % vs 66.9 %
(p = 0.4); women: 27.5 % vs 16.4 % (p = 0.2); cirrhosis presence: 70 % vs 91 % (p = 0.008); patients from surveillance: 2.6 % vs
16.4 % (p = 0.035); survival median: 371 vs 352 days (p = 0.86). When comparing subgroups of cirrhotic HCC versus non-cirrhotic
HCC we detected: age: 69 vs 68 (p = 0.); share of women: 11.9 % vs 52.6 % (p = 0.0001); NAFLD: 35.9 % vs 70.6 % (p = 0.01).
Conclusion: A significant part of patients have HCC with non-cirrhotic terrain (20 %). Aetiologically it is dominantly NAFLD.
NAFLD presents a common HCC aetiology (42 %). NAFLD is a risk factor for HCC origination in non-cirrhotic terrain. We neither
proved a statistically significant difference in survival related to aetiology nor to the presence or absence of cirrhosis.

non-alcoholic fatty liver disease, hepatocellular carcinoma, cirrhosis
Interná med. 2017; 17 (4): 167-174

Ročník 2017  Témy časopisu Internal medicine 4 / 2017

Overview works

Peter Jackuliak, Juraj Payer
Ivana Ságová, Matej Stančík, Anton Vaňuga, Dušan Pavai, Helena Urbánková, Peter Vaňuga, Anton Lacko
Ján Murín
Ľudmila Trejbalová
Eduard Veseliny, Martin Janičko, Peter Jarčuška
Jozef Polko

Original works

Marek Rác, Tomáš Koller, Andrej Klepanec, Ivan Vaňo, Marián Streško, Marián Bakoš, Peter Jarčuška, Ľubomír Skladaný
Jozef Lacka, Petra Ištokovičová, Tamara Vraždová, Peter Jackuliak
Nie sú dostupné žiadne voľne dostupné články
CHAIRMAN OF THE EDITORIAL BOARD
prof. MUDr. Ivica Lazúrová, CSc. FRCP

REPRESENTATIVE OF CHAIRMAN
prof. MUDr. Juraj Payer, CSc., FRCP

MEMBERS OF THE EDITORIAL BOARD
doc. MUDr. Viera Fábryová, CSc.
MUDr. Viera Fedelešová, CSc.
prof. MUDr Martin Haluzík, CSc.
prof. MUDr. Štefan Hrušovský, CSc. Dr.SVS.
prof. MUDr. Rudolf Hyrdel, CSc.
doc. MUDr. Oľga Jurkovičová, CSc.
doc. MUDr. Zdenko Killinger, PhD.
doc. MUDr. Soňa Kiňová, PhD.
prof. MUDr. Peter Mitro, PhD.
doc. MUDr. Viliam Mojto, CSc., MHA
prof. MUDr. Karel Pacák, DrSc.
prof. MUDr. Juraj Payer, CSc., FRCP
doc. MUDr. Ján Podoba, CSc.
prof. MUDr. Igor Riečanský, DrSc.
doc. MUDr. Ján Staško, PhD.
doc. MUDr. Mária Szántová, PhD.
prof. MUDr. Ivan Tkáč, PhD.

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Examples of citations:
1. Shaheen NJ, Crosby NA, Bozymski EM, et al. Is there publication bias in the reporting cancer risk in Barrett ́ esophagus? Gastroenterology 2000; 119: 333-338.
2. Stenestrand U, Wallentin L. Swedish Register of Cardiac Intensive Care (RIKS-HIA): Early statin treatment following acute myocardial infarction and 1-year survival. JAMA 2001; 285(4): 430-436.
3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
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Send contributions in the e-mail to the address: stachova@amedi.sk
Period 11x per year (july - august double issue)
1335-8359
The journal is indexed in the Slovak National Bibliography, Bibliographiia Medica Slovaca (BMS) and listed to citation database CiBaMed. All articles are reviewed. The publisher does not bear any responsibility for data and opinions of particular authors of the articles or advertisements. The articles on grey pages are company promotions or non reviewed information, an author is responsible for the content. Any reproduction of the content is allowed only with direct consent of the editorial office.
Predplatné
Internal medicine
Internal medicine
Peer - Reviewed Postgraduate Medical Journal.
Period 11x per year (july - august double issue)
Predplatné