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Laminin levels in ascitic fluid have been proposed as a marker for neoplastic ascites. We compared the concentration of laminin in serum and in ascitic fluid from patients with hepatic cirrhosis and peritoneal carcinomatosis and assessed the diagnostic value of serum laminin levels in differentiating neoplastic from benign ascites. Laminin concentrations were determined by ELISA with antibodies against laminin extracted from the human placenta, in patients with ascites due to peritoneal carcinomatosis (N = 20) and hepatic cirrhosis (N = 33). Patients with infected or hemorrhagic ascites were excluded. The receiver operating characteristic curve was used to determine the sensitivity and specificity of serum laminin for the diagnosis of neoplastic ascites. When compared to the group with cirrhosis, the carcinomatosis group presented significantly higher mean laminin levels in serum (3.3 +/- 0.5 vs 2.1 +/- 0.4 microg/ml, mean +/- SD, P < 0.05) and ascites (2.8 +/- 0.5 vs 1.6 +/- 0.4 microg/ml, P < 0.05). Although laminin concentration was higher in serum than in ascites, the laminin serum/ascites ratio and serum-ascites gradient did not differ between the studied groups. A significant correlation (r = 0.93, P < 0.0001) was observed between the serum and ascites laminin values. Serum laminin levels >2.25 microg/ml showed 100% sensitivity and 73% specificity for the diagnosis of neoplastic ascites. Serum concentration seems to be the main determinant of laminin levels in ascitic fluid and its values can be used as a diagnostic parameter in the study of neoplastic ascites.

Background: Serum laminin has been correlated with portal hypertension and sinusoid capillarization in chronic liver diseases. Little is known about its dynamics in liver diseases., Aim: To investigate the levels of serum laminin in experimental cirrhosis induced by carbon tetrachloride, as well as to correlate its level with the degree of hepatic fibrosis and portal hypertension., Material and Methods: Forty-nine albino Wistar rats were studied. Twenty-three were treated with carbon tetrachloride solution at 8% and 16 were kept as controls. Between the 6th and 16th weeks, all animals were sacrificed, submitted to measurement of portal pressure and blood sampling of the femoral veins. Liver fragments were fixed for light microscopic studies. Hepatic fibrosis was classified as perivenular fibrosis, complete and incomplete septal fibrosis and cirrhosis. Determination of laminin concentration was performed by ELISA with an antibody against laminin isolated from Engelbreth-Holm-Swarm tumor., Results: The portal pressure was correlated with the degree of hepatic fibrosis (rs = 0.82; n = 45). Its levels in septal fibrosis (10.8 +/- 1.2 cm H(2)0) and cirrhosis (13.6 +/- 3.1 cm H(2)0) were statistically higher when compared to control (7.9 +/- 1.5 cm H20) and perivenular fibrosis (9.1 +/- 0.8 cm H(2)0) groups. Peripheral blood laminin concentration in cirrhosis (40.0 +/- 18.7 mg/dL) was significantly higher when compared to control (13.8 +/- 12.1 mg/dL), perivenular fibrosis (19.1 +/- 15.5 mg/dL) and septal fibrosis (22.2 +/- 27.0 mg/dL) groups. The circulating laminin was correlated to the degree of hepatic fibrosis (rs = 0.59; n = 49) and to portal pressure (r = 0.29; n = 45)., Conclusions: In the chronic carbon tetrachloride intoxication, laminin levels are better correlated with the development of hepatic fibrosis than with portal hypertension.