SERUM LAMININ AND TYPE-III PROCOLLAGEN IN CHRONIC HEPATITIS-C - DIAGNOSTIC-VALUE IN THE ASSESSMENT OF DISEASE-ACTIVITY AND FIBROSIS

Laminin P1 (pepsin-resistant fragment of laminin) and aminoterminal pe ptide of type III procollagen are measurable in serum and are now cons idered useful serum markers of fibrogenesis and inflammation in chroni c liver diseases. However, very few studies thus far have focused on a ssessing the diagnostic value of these markers in detecting fibrosis a nd necro-inflammatory activity in chronically diseased liver. The aim of the present study was therefore to investigate the correlations of laminin and type III procollagen with liver histology and to compare t heir diagnostic value in detecting the degree of liver fibrosis and ne cro-inflammatory activity in a homogeneous group of 99 patients suffer ing from chronic hepatitis C, and lacking other factors which can dire ctly affect the serum levels of the two markers. Both these serum mark ers were measured by radioimmunoassay, employing commercially availabl e kits. The three main aspects of liver pathology, i.e. portal-peripor tal activity, lobular activity and fibrosis, were histologically evalu ated and semiquantitatively expressed by numerical scores. The results of this study show that laminin and type III procollagen were both po sitively correlated with the histological scores for portal-periportal activity and with those for fibrosis, whereas no significant correlat ion was observed between each of the two serum markers and the histolo gical scores for lobular activity. The sensitivity and specificity of laminin and type III procollagen in detecting histological aspects of fibrosis and disease activity in liver, computed at various cut-off le vels, showed overlapping trends for the two markers; however, the diag nostic value was in general rather low, whatever the cut-off considere d. We therefore conclude that the 'static' measurement of both serum l aminin and type III procollagen is of limited value for individual dia gnosis of liver damage. (C) 1997 Elsevier Science B.V.