The predictive value of serum laminin for the risk of variceal bleeding related to portal pressure levels
Data
1995-09-01
Autores
Miszputen, Sender Jankiel 
Parise, Edison Roberto
Tipo
Artigo
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Background/Aims: 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 (7).Patients and 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 greater than or equal to 12 mmHg, the diagnostic accuracy for such levels of serum laminin was 70%.Conclusions: Although a valid attempt in having a hypertension, peripheral serum laminin alone doesn't hypertension and to assess the risk of variceal bleeding in patients with alcoholic cirrhosis.
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Citação
Hepato-gastroenterology. Athens: H G E Update Medical Publ Ltd., v. 42, n. 5, p. 542-545, 1995.