Table 2.
The clinical application of serum laminin concentration in the assessment of liver fibrosis
| Etiology | N | Stage | Cut off | AUC | Se. (%) | Sp. (%) | NPV (%) | PPV (%) | Conclusion | Ref. |
|---|---|---|---|---|---|---|---|---|---|---|
| Hepatitis B and C | 38 | Fibrosis/cirrhosis | 2.6 U/mL (591 ng/mL) | 71 | 86 | 80 | Serum laminin can be considered a prognostic marker in liver cirrhosis. | (7) | ||
| Hepatitis B and C and AIH patients (severe vs. mild liver fibrosis). | 62 | F0-6 | 92.5 ng/mL | 0.879 | 86 | 71 | 69 | 87 | When liver biopsy is contraindicated, serum laminin levels may be useful as an additional non-invasive tool for liver fibrosis evaluation. | (9) |
| Hepatitis B and C and AIH patients (with liver fibrosis vs. without liver fibrosis) | 52.0 ng/mL | 0.974 | 94 | 78 | 86 | 91 | ||||
| Hepatitis B | 50 | F01234 | 107.5 ng/mL | 84.2 | 63.6 | 70 | 80 | Serum laminin levels could be clinically useful serum markers for predicting significant fibrosis in patients, especially when liver biopsy is contraindicated. | (10) | |
| Chronic hepatitis B | 35 | F0-6 | 64.0 ng/mL | 0.986 | 94.3 | 90 | 90 | 94.3 | Serum laminin levels can be considered an additional clinical tool for assessment of liver fibrosis, where it is impossible to perform liver biopsy. | (16) |
| Chronic hepatitis B | 87 | F ≥ 2 | 132.7 ng/mL | 0.815 | 71.9 | 80 | 60 | 87.2 | Serum laminin levels showed a positive correlation with liver fibrosis stages and would clinically be a useful serum marker for predicting significant fibrosis in patients, when liver biopsy is contraindicated. | (22) |
| Hepatitis B and C virus | 80 | Cirrhosis (F6) | 63.7 ng/mL | 0.76 | 71.4 | 81 | 73.9 | 78.9 | Serum laminin level could be used in reducing liver biopsy rates but cannot replace it. | (23) |
| Fibrosis (F>2) | 60.9 ng/mL | 0.82 | 71.4 | 77.1 | 72.9 | 75.7 | ||||
| Patient with NAFLD | 30 | F 0-4 | 282 ng/ml | 82 | 89 | 89 | 82 | Serum laminin levels may identify patients with NAFLD and fibrosis and can be considered indicators for liver biopsy. | (27) | |
| Healthy subjects | 146 | Fibrosis | 330 ng/mL | 63 | 98 | 72 | 97 | Determination of laminin cannot replace conventional diagnostic methods, and the clinical value of measuring serum laminin as a screening test for this kind of hepatic disease is not known. | (28) | |
| Patients with non hepatic diseases | 112 | Fibrosis | 63 | 81 | 68 | 77 | ||||
| Healthy subjects | 146 | Cirrhosis | 91 | 98 | 92 | 98 | ||||
| Patients with non hepatic diseases | 112 | Cirrhosis | 91 | 81 | 91 | 83 | ||||
| Healthy subjects | 146 | All | 80 | 98 | 83 | 97 | ||||
| Patients with non hepatic diseases | 112 | All | 80 | 81 | 80 | 81 |
N: number of cases, AUC: area under the curve; Se: Sensitivity; Sp: Specificity; NPV: Negative predictive value; PPV: Positive predictive value; NAFLD: non-alcoholic fatty liver disease