ALCAM and lobular neoplasia: Among them, urinary vascular cell adhesion molecule 1 (VCAM-1) and activated leukocyte cell adhesion molecule (ALCAM) are broadly validated LN biomarkers [11,66,67,68,87,95,99,100], both displaying a good ability to distinguish patients with active LN from patients with inactive LN or non-renal SLE, and correlate with markers of clinical renal disease activity (see Table 2 for the detailed metrics).