Nonalcoholic fatty liver disease (NAFLD) is showing an increasing trend world-wide and, in Western countries, it has been recognized as the most common cause of chronic elevation of liver enzymes.
Its definition includes a wide range of conditions that exhibit different histopathological patterns that lead to a distinct evolution of the natural history of the disease.
In this contest liver inflammation and fibrosis play the most relevant prognostic role, because of their strict relationship with all the liver-associated causes of morbidity and mortality.
Several noninvasive methods for the detection of liver fibrosis have been developed and tested in selected population but still liver biopsy remains the gold-standard for diagnosis and stadiation of liver disease. Thus, recognizing patient at major risk of advanced fibrosis represents the most relevant goal in clinical practice, in order to identify patients who could benefit from a systematic screening program for an early detection of cirrhosis complications and hepatocellular carcinoma (HCC).
As matter of fact, NAFLD-related HCC is becoming a tricky issue for clinicians, mostly because it often spreads in a non-cirrhotic liver, when the surveillance programs fail. The aim of this paper is to review the recent knowledge about NAFLD, underlying its epidemiological burden and discuss NAFLDassociated HCC.
Fatty liver, Non alcoholic fatty liver disease, Non-alcoholic steatohepatitis, Cirrhosis, Hepatocellular carcinoma