Among these patients, there were 1 (1.0%) class II LN, 20 (20.8%) class III/III + V LN, 54 (56.3%) class IV/IV + V LN, and 21 (21.9%) class V. Urinary ALCAM levels were significantly increased in proliferative LN (classes III and IV) (14.10 IQR (18.21) ng/mg) as compared to those in membranous LN (class V) (4.70 IQR (4.56) ng/mg, p < 0.001) (Fig. 3a). Here, ALCAM is linked to lobular neoplasia.