The emergence of non-alcoholic fatty liver disease (NAFLD) as the leading chronic liver disease worldwide raises some concerns. In particular, NAFLD is closely tied to sedentary lifestyle habits and associated with other metabolic diseases, such as obesity and diabetes. At the end of the disease spectrum, non-alcoholic steatohepatitis (NASH) may progress to cirrhosis and hepatocellular carcinoma (HCC), representing a serious health problem to modern society. Recently, an increasing number of HCC cases originating from this progressive disease spectrum have been identified, with different levels of severity and complications. Updating the current guidelines by placing a bigger focus on this emerging cause and highlighting some of its unique features is necessary. Since, the drivers of the disease are complex and multifactorial, in order to improve future outcomes, having a better understanding of NASH progression into HCC may be helpful. The risks that can promote disease progression and currently available management strategies employed to monitor and treat NASH-related HCC make up the bulk of this review.
Carcinoma, Hepatocellular/etiology* ; Humans ; Liver Cirrhosis ; Liver Neoplasms/etiology* ; Non-alcoholic Fatty Liver Disease ; Obesity

Hepatitis C ; complications ; Humans ; Liver Cirrhosis ; etiology ; Liver Neoplasms ; etiology ; Prospective Studies

Hepatitis B, Chronic ; complications ; Humans ; Liver Cirrhosis ; etiology ; surgery ; Liver Neoplasms ; surgery ; Liver Transplantation ; Living Donors

Since the hepatocellular carcinoma (HCC) develops in cirrhotic liver and is often multicentric, liver transplantation (LT) seems to be a rational approach for the treatment of HCC. Current selection criteria of LT for HCC are Milan criteria (single nodule < or = 5 cm , or < or = 3 nodules and Carcinoma, Hepatocellular/etiology/*mortality/*surgery ; Humans ; Liver Cirrhosis/*complications ; Liver Neoplasms/etiology/*mortality/*surgery ; *Liver Transplantation ; Salvage Therapy ; Survival Rate

Primary liver cancer, most of which is hepatocellular carcinoma (HCC), is the third common leading cancer in Korea. During the last two decades, the incidence rate of primary liver cancer has shown a modest decrease, but its mortality rate has slightly increased. The incidence of HCC, according to age, peaks in the late sixth decade in men and in the early seventh decade in women. Hepatitis B virus (HBV) is the most important risk factor, which represents approximately 70% of all HCC, and hepatitis C virus (HCV) and alcohol are the next in order of major risk factors for the development of HCC in Korea. HBV-associated HCC occurs 10 years earlier than HCV-associated HCC due to a more prolonged exposure to HBV, which is vertically transmitted almost from HBsAg-positive mother in HBV-endemic area. National Cancer Control Institute, which was reorganized in 2005, is now working for several national projects such as National Cancer Registration Program, National R&D Program for Cancer Control and National Cancer Screening Program. International collaboration for the clinico-epidemiologic research would be needed to provide the specific measures for managing HCC in diverse etiologic situations. Finally, the mechanisms of hepatitis virus-associated hepatocellular carcinogenesis might be clarified to provide insights into the advanced therapeutic and preventive approaches for HCC in Korea, where the majority of HCC originate from chronic HBV and HCV infections.
*Carcinoma, Hepatocellular/diagnosis/epidemiology/etiology/therapy ; Humans ; Incidence ; Korea/epidemiology ; *Liver Neoplasms/diagnosis/epidemiology/etiology/therapy

Primary liver cancer, most of which is hepatocellular carcinoma (HCC), is the third common leading cancer in Korea. During the last two decades, the incidence rate of primary liver cancer has shown a modest decrease, but its mortality rate has slightly increased. The incidence of HCC, according to age, peaks in the late sixth decade in men and in the early seventh decade in women. Hepatitis B virus (HBV) is the most important risk factor, which represents approximately 70% of all HCC, and hepatitis C virus (HCV) and alcohol are the next in order of major risk factors for the development of HCC in Korea. HBV-associated HCC occurs 10 years earlier than HCV-associated HCC due to a more prolonged exposure to HBV, which is vertically transmitted almost from HBsAg-positive mother in HBV-endemic area. National Cancer Control Institute, which was reorganized in 2005, is now working for several national projects such as National Cancer Registration Program, National R&D Program for Cancer Control and National Cancer Screening Program. International collaboration for the clinico-epidemiologic research would be needed to provide the specific measures for managing HCC in diverse etiologic situations. Finally, the mechanisms of hepatitis virus-associated hepatocellular carcinogenesis might be clarified to provide insights into the advanced therapeutic and preventive approaches for HCC in Korea, where the majority of HCC originate from chronic HBV and HCV infections.
*Carcinoma, Hepatocellular/diagnosis/epidemiology/etiology/therapy ; Humans ; Incidence ; Korea/epidemiology ; *Liver Neoplasms/diagnosis/epidemiology/etiology/therapy

Although hepatic stellate cells, which are liver specific pericytes, have been recognized within the vasculature of the sinusoid for more than one hundred years, the biology and function of these cells is unclear. Recent studies have highlighted the key role of stellate cells in a number of fundamental processes that include wound healing/fibrosis, vasoregulation, and vascular remodeling/angiogenesis. In the liver, these processes are particularly important in the development of cirrhosis, portal hypertension and cancer. This article highlights the recent advances in our understanding of the biology of hepatic stellate cells and discusses some of the recently-ascribed functions that are relevant to liver fibrosis, portal hypertension and cancer angiogenesis.
Cell Communication/physiology ; Humans ; Hypertension, Portal/*etiology ; Kupffer Cells/*physiology ; Liver Cirrhosis/*etiology ; Liver Neoplasms/blood supply/*etiology ; Neovascularization, Pathologic/etiology ; Pericytes/*physiology

OBJECTIVETo identify proteomic patterns in hepatic tissues for diagnosing early HBV related HCC.

METHODSProteomic spectra were generated by two-dimensional gel electrophoresis (2-DE), A preliminary "raining" set of spectra derived from analysis of 14 cancer tissues and 14 non-cancer tissues, a proteomic patterns that completely discriminated cancer from non-cancer was identified. The discovered pattern was then used to classify an independent set of 48 masked samples: 24 from cancer tissues, and 24 from non-cancer tissues.

RESULTSThe discriminatory pattern correctly identified all cancer tissues and non-cancer tissues in the masked set. This result yielded a sensitivity of 100%, specificity of 100%.

CONCLUSIONFurther analysis on these proteins in the proteomic pattern will be helpful to screen tumor markers for HBV related HCC. These findings justify a prospective assessment of proteomic pattern technology as a screening tool for cancer in high-risk and general populations.

Carcinoma, Hepatocellular ; diagnosis ; etiology ; Hepatitis B ; complications ; Humans ; Liver ; chemistry ; Liver Neoplasms ; diagnosis ; etiology ; Neoplasm Proteins ; analysis ; Proteomics

Carcinoma, Hepatocellular ; complications ; surgery ; Humans ; Liver Cirrhosis ; etiology ; surgery ; Liver Neoplasms ; complications ; surgery

OBJECTIVETo establish a modified rat model of liver cancer with concurrent cirrhosis for the study of carcinogenesis characteristics and drug intervention of liver cancer.

METHODSFifty male Wistar rats weighing 100-120 g were randomly divided into normal control group (20 rats) and model group (30 rats). In the model group, the rats were subjected to intraperitoneal injection of 50 mg/kg DEN N-diethylnitrosamine (DEN) twice a week for 4 consecutive weeks, followed then by weekly injections for another 10 weeks. The control rats received injections of 0.1 ml saline in the same manner. At 2, 4, 8, 12, 14, and 18 weeks, 3 rats from each group were sacrificed for assessing tumor formation and liver cirrhosis.

RESULTSLiver cancer with concurrent cirrhosis was induced successfully after 14 weeks of DEN injections. At the 14th week, 3 out of the 5 rats were found to have cirrhosis and LC, and at the 18th week, all the 3 rats examined had cirrhosis and liver cancer. The total carcinogenesis rate in the rats was 75% at 18 weeks with an overall mortality of 33%.

CONCLUSIONThis approach to establishing rat models of liver cancer with concurrent cirrhosis requires simple operation, shortens the time of carcinogenesis, and ensures a high success rate of carcinogenesis and a low mortality rate. The carcinogenesis characteristics in this model are similar to those in human.

Animals ; Liver Cirrhosis, Experimental ; complications ; pathology ; Liver Neoplasms, Experimental ; etiology ; pathology ; Male ; Rats ; Rats, Wistar