Clinical Value of Matrix Metalloproteinase 7，Glutamyl Transferase，and Total Bile Acids in the Joint Diagnosis of Biliary Atresia

Zhao NA; Hang YANG; Li CHEN; Chuanxin LI; Han XIAO; Qiang BAI

doi:10.12259/j.issn.2095-610X.S20250416

Volume 46 Issue 4

Apr. 2025

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2025 > 46(4): 123-128

Zhao NA, Hang YANG, Li CHEN, Chuanxin LI, Han XIAO, Qiang BAI. Clinical Value of Matrix Metalloproteinase 7，Glutamyl Transferase，and Total Bile Acids in the Joint Diagnosis of Biliary Atresia[J]. Journal of Kunming Medical University, 2025, 46(4): 123-128. doi: 10.12259/j.issn.2095-610X.S20250416

Citation:

Zhao NA, Hang YANG, Li CHEN, Chuanxin LI, Han XIAO, Qiang BAI. Clinical Value of Matrix Metalloproteinase 7，Glutamyl Transferase，and Total Bile Acids in the Joint Diagnosis of Biliary Atresia[J]. Journal of Kunming Medical University, 2025, 46(4): 123-128. doi: 10.12259/j.issn.2095-610X.S20250416

Citation:

Zhao NA, Hang YANG, Li CHEN, Chuanxin LI, Han XIAO, Qiang BAI. Clinical Value of Matrix Metalloproteinase 7，Glutamyl Transferase，and Total Bile Acids in the Joint Diagnosis of Biliary Atresia[J]. Journal of Kunming Medical University, 2025, 46(4): 123-128. doi: 10.12259/j.issn.2095-610X.S20250416

PDF( 728 KB)

Clinical Value of Matrix Metalloproteinase 7，Glutamyl Transferase，and Total Bile Acids in the Joint Diagnosis of Biliary Atresia

doi: 10.12259/j.issn.2095-610X.S20250416

Department of General Surgery，Kunming Children’s Hospital，Kunming Yunnan 650028，China

Received Date: 2024-11-16
Available Online: 2025-04-02
Publish Date: 2025-04-25

Abstract

Abstract

Objective To explore the value of serum matrix metalloproteinase 7 combined with glutamyl transferase and total bile acids in the diagnosis of biliary atresia. Methods 112 children hospitalized in Kunming Children's Hospital with the cholestatic jaundice from July 2023 to September 2024 were selected as the research subjects. According to the surgical exploration, intraoperative cholangiography, liver biopsy and follow-up, the children were divided into the biliary atresia group （BA）（n = 52） and non-biliary atresia group （Non-BA）（n = 60） respecvely. The age, gender, serum matrix metalloproteinase 7 （MMP-7）, glutamyl transferase （GGT）, alanine aminative aminotransferase （ALT）, aspartate aminotransferase （AST）, total bilirubin （TB）, direct bilirubin （DB）, total bile acid （TBA） and aspartate aminotransferase/platelet index （APRI） were compared between the two groups. Statistically significant indicators were included in receiver operating characteristic curve （ROC） analysis, and the area under the ROC curve （AUC） and optimal diagnostic margin （Youden index） were calculated. Results There was no significant difference in age, ALT, AST, DB, TB and APRI levels between the two groups of patients （P > 0.05）; There was a difference in gender composition ratio between the two groups （P = 0.006）; MMP-7 , GGT, TBA levels in the BA group were significantly higher than those in the Non-BA group, and the difference was statistically significant （P < 0.05）; the AUC of MMP-7, GGT, and TBA in diagnosing BA were 0.946 （95%CI 0.897～0.996） , 0.857 （95%CI 0.789～0.926）, 0.654 （95%CI 0.552～0.755） respectively; When the cut-off value of MMP-7 was 22.37 ng/ml, the sensitivity and specificity for diagnosing BA were 0.923 and 0.933 respectively; When the cut-off value of GGT was 151.5 U/L, the sensitivity and specificity of diagnosing BA were 0.885 and 0.733 respectively; When the cut-off value of TBA was 119.5 μmol/L, the sensitivity and specificity of diagnosing BA were 0.788 and 0.500, respectively. The AUC of MMP-7 + GGT and MMP-7 + TBA combined to diagnose BA were 0.971 （95%CI 0.946～0.997） and 0.943 （95%CI 0.889～0.996） respectively. Conclusion Serum MMP-7 has the good diagnostic value as a single indicator for diagnosing BA; MMP-7 combined with GGT is better than a single indicator for diagnosing BA; MMP-7 combined with TBA cannot improve the diagnostic efficiency.
- Biliary atresia,
- Matrix metalloproteinase-7,
- Glutamyl transferase,
- Bile acids,
- Diagnosis

FullText(HTML)

References(27)

References

[1]	Vij M,Rela M. Biliary atresia: Pathology,etiology and pathogenesis[J]. Future Sci OA,2020,6(5):FSO466. doi: 10.2144/fsoa-2019-0153
[2]	Nio M. Japanese Biliary atresia registry[J]. Pediatr Surg Int,2017,33(12):1319-1325. doi: 10.1007/s00383-017-4160-x
[3]	Lertudomphonwanit C,Mourya R,Fei L,et al. Large-scale proteomics identifies MMP-7 as a sentinel of epithelial injury and of biliary atresia[J]. Science Translational Medicine,2017,9(417):1-22.
[4]	Fawaz R,Baumann U,Ekong U,et al. Guideline for the evaluation of cholestatic jaundice in infants: Joint recommendations of the North American Society for pediatric gastroenterology,hepatology,and nutrition and the european society for pediatric gastroenterology,hepatology,and nutrition[J]. J Pediatr Gastroenterol Nutr,2017,64(1):154-168. doi: 10.1097/MPG.0000000000001334
[5]	Davenport M,Muntean A,Hadzic N. Biliary atresia: Clinical phenotypes and aetiological heterogeneity[J]. Journal of Clinical Medicine,2021,10(23):5675. doi: 10.3390/jcm10235675
[6]	Davenport M,Kronfli R,Makin E. Advances in understanding of biliary atresia pathogenesis and progression - a riddle wrapped in a mystery inside an enigma[J]. Expert Review of Gastroenterology & Hepatology,2023,17(4):343-352.
[7]	陈功,姜璟㼆,汤悦,等. 胆道闭锁诊断与治疗循证实践指南[J]. 中国循证儿科杂志,2022,17(4):245-259. doi: 10.3969/j.issn.1673-5501.2022.04.001
[8]	汤悦,朱叶,姜璟㼆,等. 新生儿胆道闭锁筛查和诊断系统评价和Meta分析[J]. 中国循证儿科杂志,2020,15(6):411-418. doi: 10.3969/j.issn.1673-5501.2020.06.003
[9]	Kaczmarek L. Mmp-9 inhibitors in the brain: Can old bullets shoot new targets?[J]. Curr Pharm Des,2013,19(6):1085-1089.
[10]	Garalla H M,Lertkowit N,Tiszlavicz L,et al. Matrix metalloproteinase (MMP)-7 in Barrett's esophagus and esophageal adenocarcinoma: Expression,metabolism,and functional significance[J]. Physiol Rep,2018,6(10):e13683. doi: 10.14814/phy2.13683
[11]	Leelawat K,Narong S,Wannaprasert J,et al. Prospective study of MMP7 serum levels in the diagnosis of cholangiocarcinoma[J]. World Journal of Gastroenterology,2010,16(37):4697-4703. doi: 10.3748/wjg.v16.i37.4697
[12]	Kuhlmann K F,van Till J W,Boermeester M A,et al. Evaluation of matrix metalloproteinase 7 in plasma and pancreatic juice as a biomarker for pancreatic cancer[J]. Cancer Epidemiology Biomarkers & Prevention,2007,16(5):886-891.
[13]	Morais A,Beltrao M,Sokhatska O,et al. Serum metalloproteinases 1 and 7 in the diagnosis of idiopathic pulmonary fibrosis and other interstitial pneumonias[J]. Respiratory Medicine,2015,109(8):1063-1068. doi: 10.1016/j.rmed.2015.06.003
[14]	Hung T M,Chang S C,Yu W H,et al. A novel nonsynonymous variant of matrix metalloproteinase-7 confers risk of liver cirrhosis[J]. Hepatology,2009,50(4):1184-1193. doi: 10.1002/hep.23137
[15]	Theocharis A D,Skandalis S S,Gialeli C,et al. Extracellular matrix structure[J]. Advanced Drug Delivery Reviews,2016,97(2):4-27.
[16]	Cui N,Hu M,Khalil R A. Biochemical and biological attributes of matrix metalloproteinases[J]. Progress in Molecular Biology and Translational Science,2017,147(1):1-73.
[17]	Mao X,Duan X,Jiang B. Fascin induces epithelial-mesenchymal transition of cholangiocarcinoma cells by regulating Wnt/β-catenin signaling[J]. Med Sci Monit,2016,22(9):3479-3485.
[18]	Asai A,Miethke A,Bezerra JA. Pathogenesis of biliary atresia: Defining biology to understand clinical phenotypes[J]. Nature Reviews Gastroenterology & Hepatology,2015,12(6):342-352.
[19]	Jiang J Y,Liu S Y,Du M,et al. Measurement of MMP-7 in micro-volume peripheral blood: Development of dried blood spot approach[J]. Front Pediatr,2023,1293329(11):1293329. doi: 10.3389/fped.2023.1293329
[20]	Pandurangi S,Mourya R,Nalluri S,et al. Childhood liver disease research network. Diagnostic accuracy of serum matrix metalloproteinase-7 as a biomarker of biliary atresia in a large North American cohort[J]. Hepatology,2024,80(1):152-162. doi: 10.1097/HEP.0000000000000827
[21]	Muraoka M,Yoshida S,Ohno M,et al. Reactivity of γ-glutamyl-cysteine with intracellular and extracellular glutathione metabolic enzymes[J]. FEBS Lett,2022,596(2):180-188. doi: 10.1002/1873-3468.14261
[22]	Deneau M,Perito E,Ricciuto A,et al. Ursodeoxycholic acid therapy in pediatric primary sclerosing cholangitis: Predictors of gamma glutamyltransferase normalization and favorable clinical course[J]. J Pediatr,2019,209(6):92-96.
[23]	纳钊,白强,陈莉,等. 谷氨酰转移酶直接胆红素及天冬氨酸转氨酶诊断胆汁淤积性黄疸患儿胆道闭锁的临床意义[J]. 中国妇幼保健,2024,39(20):3975-3978.
[24]	姜璟㼆,汤悦,朱叶,等. 基于超声、肝胆核素显像和磁共振胆胰管成像影像学检查诊断胆道闭锁准确性研究的系统评价和Meta分析[J]. 中国循证儿科杂志,2020,15(3):166-176.
[25]	Bathena S P,Thakare R,Gautam N,et al. Urinary bile acids as biomarkers for liver diseases II. Signature profiles in patients[J]. Toxicol Sci,2015,143(2):308-318. doi: 10.1093/toxsci/kfu228
[26]	Liu J,Lu H,Lu Y F,et al. Potency of individual bile acids to regulate bile acid synthesis and transport genes in primary human hepatocyte cultures[J]. Toxicol Sci,2014,141(2):538-546. doi: 10.1093/toxsci/kfu151
[27]	Han Y J,Hu S Q,Zhu J H,et al. Accurate prediction of biliary atresia with an integrated model using MMP-7 levels and bile acids[J]. World Journal of Pediatrics,2024,20(8):822-833. doi: 10.1007/s12519-023-00779-7

Relative Articles(20)

Relative Articles

[1]	Shuwei WANG, Yuli ZHANG, Heli LIU, Jie SU. Diagnostic Value of Ultrasonography Combined with Serum IL-1β And CYFRA21-1 in Ovarian Cancer. Journal of Kunming Medical University, 2025, 47(): 1-7.
[2]	Lisi LUO, Qingxiong YANG, Yan WANG, Sixiang LIU, Zhen XU, Yu LING. Levels of IGF-1 and IGFBP-3 in Childhood Obesity and Their Diagnostic Value. Journal of Kunming Medical University, 2025, 46(1): 123-128. doi: 10.12259/j.issn.2095-610X.S20250118
[3]	Jiong LUO, Jifeng SU, Lin WANG. Diagnosis and Treatment of 11 Cases of Primary Hepatic Neuroendocrine Tumors. Journal of Kunming Medical University, 2024, 45(11): 103-109. doi: 10.12259/j.issn.2095-610X.S20241128
[4]	Li Lan Jiang , Xu Bing Ying , Yang Chun Yan , Zhao Chuan , Tian Xin . Correlative Studies between MMP1 Gene Polymorphism and the Risk of Oral Squamous Cell Carcinomas among Han Nationality in Yunnan Province. Journal of Kunming Medical University, 2017, 38(07): 73-75.
[5]	Yang Ke , Dan Zu Jian , Zhou Qiong Hua , Wang Jun Feng . Relationship between Soluble Cytokine Receptors, Matrix Metalloproteinases and Pancreatic Cancer. Journal of Kunming Medical University, 2017, 38(01): 99-102.
[6]	Lv Song Qin . A Comparative Study of the Clinical Value of ECLIA and ELISA in the Diagnosis of Syphilis. Journal of Kunming Medical University,
[7]	Luo Xiao Mao . Application of Double Contrast-enhanced Ultrasonography in the Diagnosis of Gastric Cancer. Journal of Kunming Medical University,
[8]	Sun Dong Mei . . Journal of Kunming Medical University,
[9]	Yao Nan . . Journal of Kunming Medical University,
[10]	Yang Hong Mei . . Journal of Kunming Medical University,
[11]	Dai Qing Li . . Journal of Kunming Medical University,
[12]	Li Dong Bo . . Journal of Kunming Medical University,
[13]	Zhang Tao . . Journal of Kunming Medical University,
[14]	Fang Ke Wei . . Journal of Kunming Medical University,
[15]	Lu Jian Fei . . Journal of Kunming Medical University,
[16]	Lin Yan . . Journal of Kunming Medical University,
[17]	Li Wei Li . . Journal of Kunming Medical University,
[18]	. . Journal of Kunming Medical University,
[19]	Zhou Shao Qiang . . Journal of Kunming Medical University,
[20]	Wei Liu . . Journal of Kunming Medical University,