Elucidation of the relationship between focal cirrhosis and hepatocellular carcinoma in nonalcoholic steatohepatitis

2020 Fiscal Year Final Research Report

• Project/Area Number: 18K07637
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 52040:Radiological sciences-related
• Research Institution: Yokohama City University
• Principal Investigator: YONEDA Masato 横浜市立大学, 附属病院, 准教授 (10423831)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Keywords: 非アルコール性脂肪性肝疾患 / 肝硬変 / 肝細胞癌

Outline of Final Research Achievements

In the manegement of chronic liver disease, it is essential to correctly assess the degree of hepatic fibrosis for appropriate surveillance of hepatocellular carcinoma. In this study, we compared the diagnostic performance of ultrasound elastography and MR elastography, which are currently used as noninvastive tests (NITs). We also examined the heterogeneity of fibrosis distribution in the liver (focal cirrhosis) by　MR elastography. The diagnostic performance of MRE for fibrotic liver was higher than that of other ultrasound elastography, and the hepatic heterogeneity was as high as 30% in the same liver. The heterogeneity of liver hardness was associated with discordance with pathological biopsy.

Free Research Field

非アルコール性脂肪性肝疾患

Academic Significance and Societal Importance of the Research Achievements

非アルコール性脂肪性肝疾患（NAFLD）は最多の肝疾患であり，新規肝細胞癌発症患者の原因肝疾患としても増加傾向となっている．米国消化器病学会は2020年にNAFLD患者におけるHCCサーベイランスを行うが，高度線維化のないNAFLDではルーチンの肝細胞癌のスクリーニングは費用対効果から行うべきではないとの提言であった．しかしNAFLDの場合，肝臓内に不均一に線維化が進行して、一部が硬変肝になることがあり（Focal cirrhosis），本研究の概念により今後のHCCサーベイランス方針を変更しうる可能性を持つ．