探讨单中心非酒精性脂肪性肝病（NAFLD）相关肝细胞癌（HCC）患者的临床病理学特征。

回顾性分析2020年1月至2024年10月江南大学附属医院收治的10例NAFLD相关HCC患者临床病理学资料。其中男7例，女3例；年龄44~80岁，中位年龄71岁。所有患者均签署知情同意书，符合医学伦理学规定。分析其病史、实验室检查、影像学特点、治疗方式及预后。

10例患者中7例为体检发现肝脏占位，临床无明显症状；1例为无明显诱因的上腹痛伴发热，2例患者为无明显诱因的上腹痛伴黄疸。10例患者既往均有脂肪肝病史，均无乙肝和丙肝病史，无过量饮酒史，其中1例轻度脂肪肝，4例中度脂肪肝，5例重度脂肪肝。4例患者合并AFP升高，最高者3 000 μg/L。其中4例单纯性高血压，2例高血压合并糖尿病，1例高血压合并脑梗死。2例患者术前影像学诊断为肝血管瘤，2例术前影像学诊断为不典型良性肿瘤。7例患者均行腹腔镜肝癌根治术治疗。术后病理学检查示高分化型1例、中高分化型2例、中分化型3例、中低分化型1例，低分化型3例。术后1例出现胆漏，其余恢复顺利。住院时间为（14±4） d。随访3个月至2年，除1例患者复发外，其余患者均无复发。

NAFLD相关HCC患者常常伴随有脂肪肝，对于合并有肝脏占位的NAFLD患者，应考虑到肝癌的可能，需密切观察，定期复查，一旦确诊应及时早期手术治疗。

To investigate the clinicopathological features of non-alcoholic fatty liver disease (NAFLD)-associated hepatocellular carcinoma (HCC) in a single center.

Clinicopathological data of 10 patients with NAFLD-associated HCC admitted to Department of Hepatobiliary Surgery, Affiliated Hospital of Jiangnan University from January 2020 to October 2024 were retrospectively analyzed. Among them, 7 patients were male and 3 female, aged from 44 to 80 years, with a median age of 71 years. The informed consents of all patients were obtained and the local ethical committee approval was received. Medical history, laboratory examination, imaging features, treatment methods and clinical prognosis were analyzed.

Among 10 patients, 7 cases were diagnosed with liver space-occupying lesions by physical examination, and no evident clinical symptoms were detected. One patient developed the upper abdominal pain accompanied with fever of unknown origin, and two patients had the upper abdominal pain complicated with jaundice of unknown origin. All 10 patients had a history of fatty liver disease, neither hepatitis B, hepatitis C nor excessive drinking, including 1 case of mild fatty liver disease, 4 moderate fatty liver disease and 5 severe fatty liver disease, respectively. Four patients were complicated with elevated AFP, highest up to 3 000 μg/L. Among them, 4 patients were diagnosed with hypertension, 2 cases of hypertension complicated with diabetes mellitus, 1 case of hypertension complicated with cerebral infarction. Preoperative imaging revealed two patients were diagnosed with hepatic hemangioma, and 2 cases of atypical benign tumors. All 7 patients underwent laparoscopic radical resection of HCC. Postoperative pathological examination showed 1 case of well-differentiated HCC, 2 moderately-and well-differentiated HCC, 3 moderately-differentiated HCC, 1 moderately-and poorly-differentiated HCC and 3 poorly-differentiated HCC, respectively. One case experienced postoperative bile leakage, and the remaining patients were recovered. The length of hospital stay was (14±4) d. Follow-up endured for 3 months to 2 years. Only 1 patient recurred.

NAFLD-associated HCC patients are primarily complicated with fatty liver disease. For NAFLD patients complicated with liver masses, the possibility of liver cancer should be considered. Intimate observation and regular reexamination are needed. Prompt surgical treatment should be performed upon diagnosis.