[Present State of Non-B Non-C Liver Disease-and Its Monitoring.]

As the prevalence of lifestyle-related diseases increases, the number of individuals who have abnormal liver function test results with negative HBs antigen and anti-HCV(non-B non-C liver diseases) has been increasing. Non-B non-C liver diseases consist mainly of nonalcoholic fatty liver disease (NAFLD) and al- coholic liver disease. Non-B non-C liver cancers have been increasing in number. The identification of individuals with high risks of liver cancer is crucial for their early diagnosis and treatment. Among NAFLD individuals, nonalcoholic steatohepatitis (NASH) patients with advanced liver fibrosis have a high risk of non-B non-C liver cancers. For the diagnosis of NASH with advanced liver fibrosis, useful parameters are as follows: 1) high value of liver fibrosis markers, such as type 4 collagen 7S, 2) low platelet count (lower than 19 X 104/pL), 3) high value using a scoring system, such as the NAFLD fibrosis score and FIB-4 index, 4) high stiffness value measured by elastography, 5) advanced age, and 6) comorbidity of 3 or 4 types of lifestyle-related diseases. Alcohol drinkers consuming more than 60 g of ethanol a day are at risk of liver cancer. Obesity and diabetes mellitus are also risk factors. Individuals as described above are at risk of non-B non-C liver cancers. AFP is unlikely to show a high value in NASH liver cancer. Regular examination (every 6 months) with sonography and PIVKA-II is rec- ommended for the early diagnosis of non-B non-C liver cancers.