P3713 - Metabolic Liver Disease in HCC: Underdiagnosis and Advanced Portal Hypertension in Patients with a MASH-Consistent Phenotype in a Diverse Southwestern Cohort
Gicel J. Aguilar, BS, DO1, Tomas Escobar Gil, MD1, Mariana C. Perez Maldonado, BS2, Alan G.. Ortega-Macias, MD1, Erika Maestas, MD3, Euriko Torrazza Perez, MD, MSPH1, Eric Lawitz, MD4 1University of New Mexico, Albuquerque, NM; 2Texas College of Osteopathic Medicine, San Antonio, TX; 3University of New Mexico Health Sciences Center, Albuquerque, NM; 4Texas Liver Institute, San Antonio, TX
Introduction: Metabolic dysfunction–associated steatohepatitis (MASH) is a growing driver of hepatocellular carcinoma (HCC), yet it remains underdiagnosed, especially in underserved populations. We evaluated the prevalence, clinical profile, and diagnostic workup of patients with a metabolic phenotype suggestive of MASH in a diverse cohort from the American Southwest.
Methods: We retrospectively analyzed clinical data from 260 patients with confirmed HCC diagnosed between 2015 and 2023 at the University of New Mexico Comprehensive Cancer Center. A metabolic phenotype consistent with MASH was defined as the presence of ≥2 of the following: obesity (BMI ≥30), type 2 diabetes, and dyslipidemia. We compared tumor and hepatic biomarkers—including AFP, Fib-4, albumin, platelet counts, and portal vein thrombosis (PVT)—between patients with and without this phenotype. We also assessed use of fibrosis assessment tools (biopsy, Fibroscan).
Results: Eighty-five patients (34.1%) met criteria for a MASH-consistent phenotype. Among them, only 6% underwent liver biopsy, and just one received Fibroscan evaluation. Use of GLP-1 receptor agonists or SGLT2 inhibitors was negligible. Patients with a MASH-consistent phenotype had significantly higher rates of PVT (p = 0.035), a marker of advanced portal hypertension. Mean platelet count were numerically lower in the MASH group (132.5 × 10³/µL) compared to the non-MASH group (145.0 × 10³/µL), (p = 0.27). No significant differences were observed in AFP (p = 0.20), Fib-4 score (p = 0.97), albumin (p = 0.24), or ECOG (p = 0.64). Native American patients had the highest prevalence of this phenotype (56%) but the lowest rates of fibrosis staging (biopsy 3%, Fibroscan 0%).
Discussion: Over one-third of HCC patients in this Southwestern cohort had a metabolic phenotype consistent with MASH, yet formal fibrosis assessment and therapeutic intervention were rare. These patients demonstrated higher rates of portal vein thrombosis and numerically lower platelet counts, suggesting later-stage disease at presentation. Improved recognition of metabolic liver disease and earlier non-invasive staging are critical for optimizing care in this growing HCC population.
Disclosures:
Gicel Aguilar indicated no relevant financial relationships.
Tomas Escobar Gil indicated no relevant financial relationships.
Mariana Perez Maldonado indicated no relevant financial relationships.
Alan Ortega-Macias indicated no relevant financial relationships.
Erika Maestas indicated no relevant financial relationships.
Euriko Torrazza Perez indicated no relevant financial relationships.
Gicel J. Aguilar, BS, DO1, Tomas Escobar Gil, MD1, Mariana C. Perez Maldonado, BS2, Alan G.. Ortega-Macias, MD1, Erika Maestas, MD3, Euriko Torrazza Perez, MD, MSPH1, Eric Lawitz, MD4. P3713 - Metabolic Liver Disease in HCC: Underdiagnosis and Advanced Portal Hypertension in Patients with a MASH-Consistent Phenotype in a Diverse Southwestern Cohort, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
