Serum laminin and hyaluronan in liver cirrhosis: markers of progression with high prognostic value.

Abstract

BACKGROUND/AIMS:

In a prospective study with a mean follow-up period of 12.5 +/- 3.5 months, we investigated the extracellular matrix components laminin and hyaluronan in serum for their diagnostic value in portal hypertension and in clinically severe complications of progressive liver cirrhosis.

METHODS:

In 38 patients with liver fibrosis (n = 4) and cirrhosis (Child A: n = 17, B: n = 7, C: n = 10), the serum concentrations of laminin and hyaluronan were determined. Portal hypertension was assessed by endoscopic control of the esophageal varices and by Doppler sonography of the portal blood flow.

RESULTS:

Neither laminin nor hyaluronan correlated with portal hypertension, but highly significantly increased (p < 0.001) concentrations of 3.25 +/- 0.2 U/ml (laminin) and 493 +/- 248 ng/ml (hyaluronan) were found in patients with complications of liver cirrhosis when compared to those without complications (Ln: 2.13 +/- 0.26 U/ml, HA: 206 +/- 184 ng/ml). At cut-off levels of 2.6 U/ml (laminin) and 200 ng/ ml (hyaluronan), the diagnostic sensitivity and specificity for severe complications of liver cirrhosis was 0.71 and 0.86 (Ln) and 0.90 and 0.67 (HA), respectively. The positive predictive values were of 0.8 (laminin) and 0.6 (hyaluronan). The relative risk of patients presenting elevated concentrations of laminin or hyaluronan at the start of the study for later development of severe complications was 2.7.

CONCLUSIONS:

Both parameters, especially serum laminin, can be used as prognostic markers in addition to the Child criteria in liver cirrhosis.

• Authors: T Körner, J Kropf, A M Gressner
• Journal: Journal of hepatology (J Hepatol) Vol. 25 Issue 5 Pg. 684-8 (Nov 1996) ISSN: 0168-8278 [Print] Netherlands
• PMID: 8938546 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Laminin
• Hyaluronic Acid

Topics

• Adult
• Aged
• Analysis of Variance
• Biomarkers (blood)
• Chi-Square Distribution
• Disease Progression
• Esophageal and Gastric Varices (complications)
• Female
• Follow-Up Studies
• Humans
• Hyaluronic Acid (blood)
• Hypertension, Portal (complications)
• Laminin (blood)
• Liver Cirrhosis (blood, complications, pathology)
• Male
• Middle Aged
• Prognosis
• Prospective Studies
• Risk Assessment