CoChat
Sign Up
Cited by 336Liver Disease Diagnosis and TreatmentHepatocellular Carcinoma Treatment and PrognosisLiver Diseases and Immunity

Systematic review with meta-analysis: risk of hepatocellular carcinoma in non-alcoholic steatohepatitis without cirrhosis compared to other liver diseases

Open access
Stine, Jonathan G., Wentworth, Brian J., Zimmet, Alex, Rinella, Mary E., Loomba, Rohit, Caldwell, Stephen H., Argo, Curtis K.·2018·Alimentary Pharmacology & Therapeutics
DOI 10.1111/apt.14937PMC PMC7495494
Open this paper in CoChat — free account

Abstract

BACKGROUND: Given the lack of long-term prospective studies, it is challenging for clinicians to make informed decisions about screening and treatment decisions regarding the risk of hepatocellular carcinoma (HCC) in patients with non-alcoholic steatohepatitis (NASH) who do not have cirrhosis. AIM: To characterise the pooled risk of HCC in the non-cirrhosis population. METHODS: Published studies were identified through April 2016 in MEDLINE, Scopus, Science Citation Index, AMED and the Cochrane Library. Two independent reviewers screened citations and extracted data. Random effect odds ratios (OR) were calculated to obtain aggregate estimates of effect size between NASH and non-NASH groups. Between-study variability and heterogeneity were assessed. RESULTS: Nineteen studies with 168 571 participants were included. Eighty-six per cent of included subjects had cirrhosis. The prevalence of HCC in non-cirrhotic NASH was 38.0%; among other aetiologies in non-cirrhotics, it was 14.2% (P < 0.001). Non-cirrhotic NASH subjects were at greater odds of developing HCC than non-cirrhotic subjects of other aetiologies (OR 2.61, 95% CI 1.27-5.35, P = 0.009). When examining all NASH subjects either with or without cirrhosis, those with NASH as the underlying liver disease did not have a significantly increased risk of HCC (OR 1.43, 95% CI 0.77-2.65, P = 0.250). CONCLUSIONS: In non-cirrhotic subjects, those with NASH have a higher risk of HCC compared to other aetiologies of liver disease. Further study investigating the risk factors of HCC among non-cirrhotic NASH patients is needed.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1111/apt.14937

Cites

55 of 55 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • 36.6~50% of HCC in MASH patients develop without cirrhosis.

    “Of note, 36.6 ~ 50% of HCC in MASH patients develop without cirrhosis [7–9]”

    From Single-cell transcriptome reveals the reprogramming of immune microenvironment during the transition from MASH to HCC (2025) · cites this paper as [9]

    The Introduction states that NASH-associated HCC can develop without cirrhosis. The Results section on HCC in NASH patients without cirrhosis reports 38.0% as the prevalence of HCC among noncirrhotic NASH patients—not the percentage of NASH-associated HCC cases that arise without cirrhosis. It does not establish the claimed 36.6–50% range. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Several studies have shown that individuals with MASLD without cirrhosis may develop HCC, albeit rarely.

    “several studies have shown that individuals with MASLD without cirrhosis may develop HCC, albeit rarely. 230”

    From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [230]

    The Introduction says NASH-associated HCC may develop without cirrhosis, and the Results pool seven studies of noncirrhotic NASH patients. The source studies NASH rather than the broader MASLD population and does not establish that HCC develops only rarely; its reported 38.0% prevalence is from the included study populations, not a general-population incidence estimate. Page numbers are unavailable in our copy. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

1 of the 56 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. [9]Tokushige K, Hashimoto E, Kodama K. Hepatocarcinogenesis in nonalcoholic fatty liver disease in Japan. J Gastroenterol Hepatol. 2013; 28(Suppl. 4): 88– 92. 24251711
  2. [41]Hsiang JC, Bai WW, Raos Z, Epidemiology, disease burden and outcomes of cirrhosis in a large secondary care hospital in South Auckland, New Zealand. Int Med J. 2015; 45(2): 160– 169. 25371019
  3. [48]Piscaglia F, Svegliati-Baroni G, Barchetti A, Clinical patterns of hepatocellular carcinoma (hcc) in non alcoholic fatty liver disease (NAFLD): a multicenter prospective study. Hepatology. 2015; 63: 827– 838. 26599351

Cited by

Sorted by citations

Related

Authors
Stine, J. G., Wentworth, B. J., Zimmet, A., Rinella, M. E., Loomba, R., Caldwell, S. H., & Argo, C. K.
Affiliations
  • University of Virginia (US)
  • Northwestern University (US)
  • University of California San Diego (US)
Corresponding author
Stine, Jonathan G.
ORCID
Venue
Alimentary Pharmacology & Therapeutics
Publisher
Wiley
Published
2018-08-22
Volume
48
Issue
7
Pages
696-703
ISSN
  • 0269-2813 (ISSN-L)
  • 1365-2036
DOI
10.1111/apt.14937
PMC
PMC7495494
OpenAlex
W2888434946
Cited by
336
References
56
Citations by year
2026: 21 · 2025: 47 · 2024: 46 · 2023: 59 · 2022: 50 · 2021: 51 · 2020: 31 · 2019: 23 · 2018: 6
FWCI
3.97
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Alimentary Pharmacology & Therapeutics (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institutes of Health
  • American Association for the Study of Liver Diseases
Topics
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
  • Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
Keywords
hepatocellular carcinoma, nonalcoholic steatohepatitis, non-cirrhotic liver disease, liver cirrhosis, hepatocellular carcinoma risk, liver disease aetiology, HCC incidence
MeSH terms
Carcinoma, Hepatocellular, Humans, Liver Cirrhosis, Liver Diseases, Liver Neoplasms, Prospective Studies, Risk Factors, Cohort Studies, Case-Control Studies, Observational Studies as Topic, Non-alcoholic Fatty Liver Disease

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review