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近日，2024年新加坡GIHep与肝病联合大会（Combined GlHep & SHC 2024）在新加坡成功举办。本次会议涵盖了肝病研究的各个方面，给广大专家学者搭建了一个跨学科的交流平台。会议期间，《国际肝病》特邀新加坡陈笃生医院高级顾问医生尤国超围绕代谢相关性脂肪性肝病（MASLD）等相关内容进行了探讨。

《国际肝病》

您认为本次会议对提高亚太地区乃至全球的肝病研究和治疗水平有何重要意义？您在本次大会上有何收获？

尤国超医生：这次会议为我们提供了亚太地区以及全球肝病研究的最新信息与进展。纵观全局，会议的重点话题有MASLD、乙型肝炎治愈努力的探讨等。此外，世界卫生组织（WHO）指导方针的更新，以及中国扩大适应证的举措，都为我们提供了新的视角和启示。有研究证据表明，扩大适应证可以给患者带来长期获利益，特别是显著降低了肝癌的发病率。

我还看到会上有很多论文摘要和口头报告，这些研究很有意义，提供了研究者本国的临床数据，尤其是来自南亚地区的数据。

Hepatology Digest：What significant implications do you think this conference has in enhancing liver disease research and treatment levels in the Asia-Pacific region and even globally? What have you gained from this conference?

Dr.Yew Kuo Chao：I think this conference has actually provided us with a lot of updates in the Asia-Pacific region, as well as new advancements from a global perspective. Looking at the landscape, the diseases chosen as a focus include MASLD, the new nomenclature for what was previously called fatty liver disease, and the current efforts toward a Hepatitis B cure. To aim for a cure, there was a challenge, and there was an update in terms of guidelines from the WHO. China has also loosened its treatment criteria, with evidence showing long-term benefits, especially in reducing liver cancer.

We also had a lot of interesting data presented by local regional hospitals in terms of abstracts and oral presentations, which were fascinating to look at regarding innovation and new perspectives, especially from the South Asia region.

《国际肝病》

针对MASLD向MASH发展，甚至进一步可能发展为肝细胞癌（HCC）的病程，您认为当前有哪些有效的干预手段？

尤国超医生：在现阶段，这个问题很难回答。我们现在的理解是，MAFLD实际上属于代谢综合征的范畴。当前，许多药物联合治疗在针对心血管、肾脏、HCC和肝纤维化等方面显示出了一定的疗效。然而，患者一旦进展为肝硬化，便很难逆转纤维化。会上，有人提到了疾病治疗的毛细血管化和血管生成，这可能为MASH肝硬化患者提供新突破。

我个人认为，MAFLD未来的治疗方向将更加个性化，没有哪一种单一的干预措施能够适用于所有患者。因此，我们需要结合遗传学、表观遗传学以及生活方式来干预，为患者提供个体化的治疗方案。在组织学和纤维化改善方面，目前已经取得了显著的进步，例如纤维化逆转率达到了50%～60%，这是医学的显著进步。

Hepatology Digest：Regarding the progression of MASLD to MASH and potentially further to hepatocellular carcinoma, what effective intervention methods do you think are currently available?

Dr.Yew Kuo Chao：This is quite a challenging question to answer at this stage of development. What we understand now is that it is actually under the metabolic syndrome umbrella. At the moment, there are a lot of pharmacological combinations targeting multiple aspects to provide total efficacy in outcomes like cardiovascular, renal, HCC (hepatocellular carcinoma), and liver fibrosis. There's also some insight into the cirrhosis stage, which is more difficult to treat and reverse. There has been mention of the capillarisation and angiogenesis of the disease, which may be a new target for this MASH cirrhosis group of patients.

Personally, I think we're moving towards a personalized approach. Not one single intervention will fit all patients. We have to integrate genetics, epigenetics, and lifestyle interventions to restratify the patient, allowing them to choose the appropriate management. It's very interesting, and in terms of histology and fibrosis improvement, there's been an advancement achieving about 50-60% fibrosis reversal. This is a remarkable step forward in medical advancement for us.