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Diagnostic Accuracy of Serum Matrix Metalloproteinase-7 for Biliary Atresia
Li Yang1,2, Ying Zhou1, Pei-Pei Xu1
1Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
Diagnosing biliary atresia (BA) is challenging. A new study shows serum matrix metalloproteinase-7 (MMP-7) levels can accurately identify BA in infants, aiding early diagnosis and treatment.
Area of Science:
- Pediatric Gastroenterology
- Biomarker Discovery
- Neonatal cholestasis research
Background:
- Biliary atresia (BA) diagnosis is difficult due to overlapping symptoms with other neonatal cholestasis causes.
- Early BA diagnosis and treatment are crucial for improved infant outcomes.
Purpose of the Study:
- To evaluate the diagnostic accuracy of serum matrix metalloproteinase-7 (MMP-7) for biliary atresia (BA).
- To establish normal MMP-7 concentrations and compare them in infants with BA, non-BA, and healthy controls.
Main Methods:
- Serum MMP-7 concentrations were measured in 135 infants evaluated for cholestasis.
- Included healthy controls, infants with non-BA, and infants with BA.
- Statistical analysis, including ROC curve, determined diagnostic performance.
Main Results:
- Median MMP-7 levels were significantly different across groups: controls (2.86 ng/mL), non-BA (11.47 ng/mL), and BA (121.1 ng/mL).
- MMP-7 demonstrated high diagnostic accuracy (AUC 0.9900) with a cutoff of 52.85 ng/mL.
- Sensitivity was 98.67%, specificity 95.00%, and negative predictive value 98.28% for BA.
Conclusions:
- Serum MMP-7 is a highly sensitive and specific biomarker for differentiating BA from other neonatal cholestasis.
- MMP-7 assay offers a reliable tool for early and accurate BA diagnosis.
Abstract:
The diagnosis of biliary atresia (BA) remains a clinical challenge because affected infants have signs, symptoms, and serum liver biochemistry that are also seen in those with other causes of neonatal cholestasis (non-BA). However, an early diagnosis and prompt surgical treatment are required to improve clinical outcome. Recently, the relative abundance of serum matrix metalloproteinase-7 (MMP-7) was suggested to have discriminatory features for infants with BA. To test the hypothesis that elevated serum concentration of MMP-7 is highly diagnostic for BA, we determined the normal serum concentration of MMP-7 in healthy control infants, and then in 135 consecutive infants being evaluated for cholestasis. The median concentration for MMP-7 was 2.86 ng/mL (interquartile range, IQR: 1.32-5.32) in normal controls, 11.47 ng/mL (IQR: 8.54-24.55) for non-BA, and 121.1 ng/mL (IQR: 85.42-224.4) for BA (P < 0.0001). The area under the curve of MMP-7 for the diagnosis of BA was 0.9900 with a cutoff value of 52.85 ng/mL; the diagnostic sensitivity and specificity were 98.67% and 95.00%, respectively, with a negative predictive value of 98.28%. Conclusion: Serum MMP-7 assay has high sensitivity and specificity to differentiate BA from other neonatal cholestasis, and may be a reliable biomarker for BA.
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