Application Value Of Serum MMP-7 Level In The Early Diagnosis Of Children With Biliary Atresia

Objective:To investigate the application value of MMP-7 in the early diagnosis of biliary atresia(BA),we compared the difference of serum matrix metalloproteinase-7(MMP-7)levels in the biliary atresia group,non-biliary atresia group and the control group.Methods: From July 2019 to November 2020,a total of 42 children with biliary atresia diagnosed by our hospital were selected(69 times of MMP-7 test were performed at different stages of the disease),53 children with non-biliary atresia cholestasis were selected(55 times of MMP-7 test at different stages of the disease).During the same period,83 children with normal liver function had diarrhea were used as the control group.The results of all clinical examination indexes were recorded.All enrolled children’s native place and birth place were in the Northeast of China(Heilongjiang,Jilin,Liaoning,and Eastern Inner Mongolia).Serum MMP-7levels were detected by enzyme linked immunosorbent assay(ELISA),and the difference of MMP-7 levels in each group was analyzed to evaluate the efficacy of MMP-7 in the early diagnosis of biliary atresia.SPSS 25.0 software was used for statistical analysis of the data.Results:1.Means of serum MMP-7 concentrations in the biliary atresia group,non-bilia ry atresia cholestasis group and control group were 2.68ng/m L(IQR:2-5.1),1.88ng/m L(IQR:1.37-2.96)and 1.35ng/m L(IQR:1.13-1.78),respectively.And the diffe rence of MMP-7 concentrations among the three groups was statistically signifi cant(p<0.001).2.The cutoff value of serum MMP-7 for BA diagnosis was 1.94ng/m L.The sensitivity and specificity were 82.4% and 63.3%,respectively.The area under the Receiver operating characteristic curve is 0.737.The cutoff value of serum GGT for BA diagnosis is 295.1U/L,The sensitivity and specificity were 63.8% and 89.1%,respectively.The area under the ROC(AUC)was 0.817.The sensitivity and specificity of MMP-7 combined with the GGT were 68.1% and 80%,respectively.The area under the ROC(AUC)was 0.819.3.There was significant positive correlation between serum MMP-7 and GGT concentration in BA group(r=0.351,P =0.003).4 There was no significant correlation between MMP-7 concentration and liver fibrosis level in BA group(r=0.06,P =0.677).Conclusion:1.The serum concentration of MMP-7 in children with biliary atresia group was significantly higher than that in the non-biliary atresia group and the control group;Compared with the control group,the non-biliary atresia cholestasis group also showed an increased trend.2.Serum MMP-7 concentration had good diagnostic value for biliary atresia,with cutoff value of 1.94ng/m L,sensitivity and specificity of 82.4% and 63.3%,respectively,which can be used as a biomarker for early diagnosis of BA.Combined with GGT can improve the specificity of MMP-7 in the diagnosis of BA.3.Serum MMP-7 was significantly positively correlated with the level of GGT,suggesting that MMP-7 may be involved in the process of bile duct injury in biliary atresia,but there was no significant correlation with the level of liver fibrosis.