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Prognostic Value of Combined Detection of MMP-7 and ALP Levels in Children With Biliary Atresia Post-Kasai Surgery
Qingzhi Li1, Chaoxiang Ye1, Wei Gao1
1Department of Neonatal Surgery, Anhui Children's Hospital, Hefei, China.
Insights
High levels of serum matrix metalloproteinases 7 (MMP-7) and alkaline phosphatase (ALP) predict the need for liver transplantation (LT) in biliary atresia (BA) children after Kasai surgery. Their combined detection significantly improves LT prediction in these pediatric patients.
Area of Science:
- Pediatric Gastroenterology and Hepatology
- Biomarker Discovery
- Surgical Outcomes Research
Background:
- Biliary atresia (BA) is a primary indication for pediatric liver transplantation (LT).
- Predicting post-Kasai surgery outcomes in BA patients is crucial for clinical management.
- The prognostic role of specific biomarkers requires further investigation.
Purpose of the Study:
- To evaluate the prognostic value of combined serum matrix metalloproteinases 7 (MMP-7) and alkaline phosphatase (ALP) levels in biliary atresia (BA) children post-Kasai surgery.
- To determine if these biomarkers can predict the need for liver transplantation (LT).
Main Methods:
- Retrospective analysis of 85 BA children undergoing Kasai surgery, categorized by 3-year prognosis (native liver vs. LT).
- Serum MMP-7 and ALP levels measured via ELISA; correlated with preoperative gamma-glutamyltransferase (GGT).
- Cox regression and ROC curve analysis identified independent risk factors and predictive value of combined MMP-7 and ALP for LT.
Main Results:
- Higher intraoperative serum MMP-7 and ALP levels were observed in the LT group, correlating positively with preoperative GGT.
- High MMP-7 and ALP levels were identified as independent risk factors for LT, while jaundice clearance was protective.
- Combined MMP-7 and ALP detection demonstrated high predictive accuracy (0.926 AUC, 91.30% sensitivity, 87.18% specificity) for LT.
Conclusions:
- Elevated serum MMP-7 and ALP levels are significant independent risk factors for post-Kasai surgery LT in biliary atresia (BA) children.
- The combination of MMP-7 and ALP offers superior predictive value for LT in this pediatric population.
Objective:
Biliary atresia (BA) remains a prevalent indication for pediatric liver transplantation (LT). We investigated the prognostic value of the serum matrix metalloproteinases 7 (MMP-7) and alkaline phosphatase (ALP) level combined detection for BA children post-Kasai surgery.
Methods:
This study retrospectively enrolled 85 BA children who underwent Kasai surgery. They were divided into the native liver (NL) and LT groups based on their three-year postoperative prognosis. Serum MMP-7 and ALP levels were measured by ELISA. The relationship of intraoperative serum MMP-7 and ALP levels with preoperative gamma-glutamyltransferase (GGT), and their impact on the risk of postoperative LT were analyzed by Pearson's correlation coefficient and Kaplan-Meier curves. The independent risk factors (IRFs) for postoperative LT and the predictive value of the serum MMP-7 and ALP level combined detection for postoperative LT in BA children were analyzed by Cox regression analysis and receiver operating characteristic (ROC) curves. MedCalc software compared the areas under the ROC curves (AUC).
Results:
Significant differences were observed between the two groups in BA classification, postoperative jaundice clearance rate, and cholangitis occurrence. Intraoperative serum MMP-7 and ALP levels were higher in the LT group and positively correlated with preoperative GGT. High MMP-7 and ALP levels were IRFs for postoperative LT, while significant jaundice clearance was a protective factor. Combined MMP-7 and ALP detection (0.926 AUC, 91.30% sensitivity, 87.18% specificity) significantly improved the prediction for LT.
Conclusion:
High MMP-7 and ALP levels are IRFs for post-Kasai surgery LT in BA children, with their combination providing superior predictive value.
