Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, with an incidence that is exponentially increasing. Hepatocellular carcinoma (HCC) is the most frequent primary tumor. There is an increasing relationship between these entities due to the potential risk of developing NAFLD-related HCC and the prevalence of NAFLD. There is limited evidence regarding prognostic factors at the diagnosis of HCC. This study compares the prognosis of HCC in patients with NAFLD against other etiologies. It also evaluates the prognostic factors at the diagnosis of these patients. For this purpose, a multicenter retrospective study was conducted involving a total of 191 patients. Out of the total, 29 presented NAFLD-related HCC. The extreme gradient boosting (XGB) method was employed to develop the reference predictive model. Patients with NAFLD-related HCC showed a worse prognosis compared to other potential etiologies of HCC. Among the variables with the worst prognosis, alcohol consumption in NAFLD patients had the greatest weight within the developed predictive model. In comparison with other studied methods, XGB obtained the highest values for the analyzed metrics. In conclusion, patients with NAFLD-related HCC and alcohol consumption, obesity, cirrhosis, and clinically significant portal hypertension (CSPH) exhibited a worse prognosis than other patients. XGB developed a highly efficient predictive model for the assessment of these patients.
非酒精性脂肪性肝病（NAFLD）是全球最常见的慢性肝病，其发病率呈指数级增长。肝细胞癌（HCC）是最常见的原发性肝脏肿瘤。由于NAFLD相关HCC的潜在风险及NAFLD的高患病率，这两种疾病之间的关联日益密切。目前关于HCC诊断时预后因素的证据有限。本研究比较了NAFLD患者与其他病因所致HCC患者的预后差异，并评估了诊断时的预后影响因素。为此，我们开展了一项多中心回顾性研究，共纳入191例患者，其中29例为NAFLD相关HCC。研究采用极端梯度提升（XGB）方法构建参考预测模型。结果显示，NAFLD相关HCC患者较其他病因的HCC患者预后更差。在预后不良的影响因素中，NAFLD患者的饮酒行为在预测模型中权重最高。与其他研究方法相比，XGB在各项评估指标中均获得最优值。综上所述，伴有饮酒、肥胖、肝硬化及临床显著门静脉高压（CSPH）的NAFLD相关HCC患者预后较其他患者更差。XGB构建的预测模型能高效评估此类患者的预后情况。
肿瘤(癌症)患者之家