编者按：“中华医学会肝病学分会2016年全国肝病学术年会暨中华医学会肝病学分会青年委员会第三届青年论坛暨第六届中国-印度尼西亚联合肝病峰会”召开期间，来自印度尼西亚大学的L.A.Lesmana教授在全体大会上介绍了“HCC in Jakarta（Indonesia Liver Cancer Study Group）”，并于会后就印度尼西亚肝癌发病情况及脂肪肝对肝癌的影响话题，接受了《国际肝病》的专访。

 

　　《国际肝病》：在印度尼西亚，影响肝癌发生的相关疾病有哪些？

 

　　: As is known to all, a variety of chronic liver disease can induce hepatocellular carcinoma (HCC), so what is the primary cause of HCC currently in Indonesia?

 

　　L.A.Lesmana教授：我认为，在印度尼西亚，肝癌的发生主要与肝炎相关，最主要的原因是乙型病毒性肝炎（HBV），其次是丙型病毒性肝炎（HCV），但目前有数据显示，脂肪肝患者也可能发展为肝癌。此外，还有其他情况如糖尿病，也会发展为肝癌。

 

　　总体而言，目前在印度尼西亚，肝癌发生的相关因素除HBV和HCV外，还有脂肪肝、糖尿病，以及一些自身免疫性疾病。

 

　　Prof. Lesnama：I think it is the hepatitis in Indonesia regarding the cause, I think the most cause is HBV, and followed by HCV, but currently, we are also data those patients with fatty liver can also develop with hepatocellular carcinoma. And furthermore, also other conditions like diabetes mellitus, I mean, also develop hepatocellular cancer. So I think, several factors now, in Indonesia, that will develop in some patients with hepatocellular carcinoma, not only by viral hepatitis B and C virus infection but also if they are have a fatty liver, and also diabetes mellitus, also some autoimmune diseases which can induce hepatocellular carcinoma (HCC).

 

　　《国际肝病》：在印度尼西亚，非酒精性脂肪性肝病（NAFLD）的发病情况如何？

 

　　: Nonalcoholic fatty liver disease have been more and more taken seriously in recent years, excuse me, professor, could you talk about the prevalence of NAFLD in Indonesia？What is the relationship between NAFLD and cirrhosis and HCC ?

 

　　L.A.Lesmana教授：正如我前面所提到的，来自雅加达的数据告诉我们，许多NAFLD患者也可以发展为肝癌，所以很多肝癌患者主要与NAFLD相关，而不是与HBV或HCV感染相关。如今，印度尼西亚的NAFLD发病率越来越高。在雅加达的一家医院，我们发现在常规检查的人群中，约50%为脂肪肝患者。

 

　　为此，我们制定了一项旨在降低脂肪肝发病率的计划。虽然这并不是一件容易的事，但NAFLD可能进展为肝硬化甚至肝癌的客观事实迫使我们坚持完成这项计划。在后续诊断方面，我们通过Fibroscan?来观察脂肪肝患者是否发生肝炎甚至肝硬化。

 

　　总之，NAFLD已成为印度尼西亚的一个非常大的健康卫生问题，我们有责任，与政府携手，降低印度尼西亚的NAFLD患病率。

 

　　Prof. Lesnama： As I mentioned, based on our data from Jakarta, many patients with NAFLD can also develop HCC so we have a lot of patients with HCC primarily related to NAFLD and not to hepatitis B and C. Nowadays, the incidence of NAFLD is increasing in Indonesia. For instance, in one hospital in Jakarta, we found that around 50% of patients who came in for a routine checkup had fatty liver. Consequently, we have been developing a program to reduce the incidence of fatty liver. It will not be easy, but I think now we know that NAFLD progresses to liver cirrhosis and then on to HCC, it is important. In terms of follow-up of diagnosis, we use FibroScan, for instance, to see if patients with fatty liver are showing inflammation of the liver and even liver cirrhosis. NAFLD has become a very big problem in our country and it is our duty to the community, hand-in-hand with the government, to reduce the prevalence of NAFLD in Indonesia.

 

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