SERUM LAMININ AND PROCOLLAGEN IN ALCOHOLI C LIVER-DISEASE - ITS VALUEAS PREDICTORS OF THE DEGREE OF FIBROSIS

Aim: To determine the clinical and prognostic value of serum laminin i n chronic alcoholic liver disease and to discern whether laminin, alon e or in combination with serum N-terminal type III collagen propeptide , and/or biochemical parameters, is useful in estimating the histomorp hometrically determined amount of fibrosis. Study design: Prospective. Patients: 121 (80 of them cirrhotics), 107 followed up for a variable periods ranging from 1 to 1440 days. Results: Serum laminin was highe r in cirrhotic patients belonging to Child's C group and, in cirrhotic patients, it significantly correlated with Pugh's score (r = 0.32, p < 0.01), prothrombin activity (r = 0.23, p < 0.05), serum albumin (r = -0.35, p < 0.001) and bilirubin (r = 0.30, p < 0.01), and also with t he degree of fibrosis (r = 0.49, p < 0.001). Serum laminin over 3.5 U/ mL were associated to higher mortality rates in the total population ( Log rank test = 4.9, p = 0.022), but not in cirrhotics. Stepwise multi ple regression analysis showed that laminin is useless in the estimati on of liver fibrosis in cirrhotics, although in non-cirrhotic alcoholi cs, serum laminin together with alkaline phosphatase and GGT roughly e stimates the amount of liver fibrosis (r = 0.72, p < 0.001, standard e rror = 7.29). Conclusions: Laminin is not useful in estimating the tot al amount of fibrosis neither in prognostic assessment of cirrhotics. However, serum laminin values over 3.5 U/ml were associated with highe r mortality rates in patients with chronic alcoholic liver disease, an d serum laminin together with alkaline phosphatase and GGT correlated with the amount of fibrosis in the non-cirrhotic subgroup.