دورية أكاديمية
أعرض في EDS

Serum matrix metalloproteinase-7 for discriminating biliary atresia: a diagnostic accuracy and validation study.

التفاصيل البيبلوغرافية
العنوان: Serum matrix metalloproteinase-7 for discriminating biliary atresia: a diagnostic accuracy and validation study.
المؤلفون: Jiang J; Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Children's Hospital of Fudan University, Ministry of Health, 399 Wan Yuan Road, Shanghai, 201102, China., Dong R; Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Children's Hospital of Fudan University, Ministry of Health, 399 Wan Yuan Road, Shanghai, 201102, China., Du M; Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Children's Hospital of Fudan University, Ministry of Health, 399 Wan Yuan Road, Shanghai, 201102, China., Chen G; Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Children's Hospital of Fudan University, Ministry of Health, 399 Wan Yuan Road, Shanghai, 201102, China., Yang J; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA., Xie X; Department of Hepatology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China., Yang Y; Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Children's Hospital of Fudan University, Ministry of Health, 399 Wan Yuan Road, Shanghai, 201102, China., Yan W; Department of Clinical Epidemiology, Clinical Trial Unit, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China. yanwl@fudan.edu.cn., Zheng S; Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Key Laboratory of Neonatal Disease, Children's Hospital of Fudan University, Ministry of Health, 399 Wan Yuan Road, Shanghai, 201102, China. szheng@shmu.edu.cn.
المصدر: Journal of translational medicine [J Transl Med] 2024 Jul 08; Vol. 22 (1), pp. 636. Date of Electronic Publication: 2024 Jul 08.
نوع المنشور: Journal Article; Validation Study
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101190741 Publication Model: Electronic Cited Medium: Internet ISSN: 1479-5876 (Electronic) Linking ISSN: 14795876 NLM ISO Abbreviation: J Transl Med Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BioMed Central, 2003-
مواضيع طبية MeSH: Biliary Atresia*/blood , Biliary Atresia*/diagnosis , Matrix Metalloproteinase 7*/blood , ROC Curve*, Humans ; Infant ; Male ; Female ; Infant, Newborn ; Reproducibility of Results ; Retrospective Studies ; Diagnosis, Differential ; Child, Preschool ; Cholestasis/blood ; Cholestasis/diagnosis ; Prospective Studies
مستخلص: Background: Prompt and precise differential diagnosis of biliary atresia (BA) among cholestatic patients is of great importance. Matrix metalloproteinase-7 (MMP-7) holds great promise as a diagnostic marker for BA. This study aimed to investigate the accuracy of age-specific serum MMP-7 for discriminating BA from other cholestatic pediatric patients.
Methods: This was a single center diagnostic accuracy and validation study including both retrospective and prospective cohorts. Serum MMP-7 concentrations were measured using an ELISA kit, the trajectory of which with age was investigated in a healthy infants cohort aged 0 to 365 days without hepatobiliary diseases (n = 284). Clinical BA diagnosis was based on intraoperative cholangiography and subsequent histological examinations. The diagnostic accuracy of age-specific cutoffs of serum MMP-7 were assessed in a retrospective cohort of cholestatic patients (n = 318, with 172 BA) and validated in a prospective cohort (n = 687, including 395 BA).
Results: The MMP-7 concentration declines non-linearly with age, showing higher levels in healthy neonates as well as higher cutoff value in neonatal cholestasis. The area under the ROC curve (AUROC) was 0.967 (95% confidence interval [CI]: 0.946-0.988) for the retrospective cohort, and the cutoff of 18 ng/mL yielded 93.0% (95%CI: 88.1-96.3%), 93.8% (95%CI: 88.6-97.1%), 94.7% (95%CI: 90.1-97.5%), and 91.9% (95%CI: 86.4-95.8%) for sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), respectively. The performance of MMP-7 was successfully validated in the larger prospective cohort, resulting in a diagnostic sensitivity of 95.9% (379/395; 95% CI: 93.5-97.7%), a specificity of 87.3% (255/292; 95% CI: 83.0-90.9%), a PPV of 91.1% (379/416; 95% CI: 87.9-93.7%), and a NPV of 94.1% (255/271; 95% CI: 90.6-96.6%), respectively. Besides, higher cutoff value of 28.1 ng/mL achieved the best sensitivity, specificity, PPV, and NPV for infants aged 0-30 days, which was 86.4% (95% CI: 75.0-94.0%), 95.5% (95% CI: 77.2-99.9%), 98.1% (95% CI: 89.7-100%), and 72.4% (95% CI: 52.8-87.3%), respectively.
Conclusions: The serum MMP-7 is accurate and reliable in differentiating BA from non-BA cholestasis, showing its potential application in the diagnostic algorithm for BA and significant role in the future research regarding pathogenesis of BA.
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: Biliary atresia; Biomarker; Cholestasis; Cutoff value; Diagnostic accuracy; MMP-7; Neonate
المشرفين على المادة: EC 3.4.24.23 (Matrix Metalloproteinase 7)
تواريخ الأحداث: Date Created: 20240708 Date Completed: 20240709 Latest Revision: 20240711
رمز التحديث: 20240711
مُعرف محوري في PubMed: PMC11229253
DOI: 10.1186/s12967-024-05442-x
PMID: 38978022
قاعدة البيانات: MEDLINE
الوصف
تدمد:1479-5876
DOI:10.1186/s12967-024-05442-x