title: The predictive value of serum laminin for the risk of variceal bleeding related to portal pressure levels.
abstract: OBJECTIVE
  This paper presents the results of the radioimmunologic determination of laminin in serum of patients with alcoholic liver cirrhosis with a preserved hepatic function, trying to evaluate its predictive value for the risk of variceal bleeding, assessed by a portal pressure level equal to or higher than 12 mmHg.
  
  
  METHODS
  Twenty alcoholic cirrhotic patients with a preserved hepatic function as assessed by the Child-Pugh classification, had their peripheral blood taken for radioimmunological determination of serum laminin and were submitted to hepatic vein catheterization for portal pressure measurement.
  
  
  RESULTS
  A positive and significant correlation (r = 0.70, p < 0.001) was found between serum laminin levels (mean value + SD = 2.70 + 1.13 U/ml) and hepatic vein pressure gradient (mean HVPG + SD = 16.30 + 6.06 mmHg). Such correlation prompted us to find a value for the level of laminin that more closely represented a HVPG of 12 mmHg, a well known threshold pressure for esophageal varices bleeding. At a cut-off concentration for laminin of 2.19 U/ml, sensitivity was 73%, specificity 60%, the positive predictive value was 85% and the negative predictive value 43%. In this study population, with a prevalence of 75% of a HVPG > or = 12 mmHg, the diagnostic accuracy for such levels of serum laminin was 70%.
  
  
  CONCLUSIONS
  Although a valid attempt in having a non invasive parameter for the investigation of portal hypertension, peripheral serum laminin alone doesn't seem to be a reliable marker for predicting portal hypertension and to assess the risk of variceal bleeding in patients with alcoholic cirrhosis.
authors: Gastroenterology Section, Escola Paulista De Medicina, Sao Paulo, Brazil.
authors: M
authors: M
authors: Kondo
authors: S J
authors: SJ
authors: Miszputen
authors: M M
authors: MM
authors: Leite-mor
authors: E R
authors: ER
authors: Parise
mesh_terms: D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000097:blood / Q000150:complications*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000097:blood / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D007797:Laminin / Q000097:blood*; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D017082:Portal Pressure / Q000502:physiology*; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D007797:Laminin