胆道闭锁患者血清基质金属蛋白酶-7：一项日本多中心研究。

Serum matrix metalloproteinase-7 in biliary atresia: A Japanese multicenter study.

作者信息

Sakaguchi Hirotaka, Konishi Ken-Ichiro, Yasuda Ryosuke, Sasaki Hideyuki, Yoshimaru Koichiro, Tainaka Takahisa, Fukahori Suguru, Sanada Yukihiro, Iwama Itaru, Shoji Hiromichi, Kinoshita Masahiro, Matsuura Toshiharu, Fujishiro Jun, Uchida Hiroo, Nio Masaki, Yamashita Yushiro, Mizuochi Tatsuki

机构信息

Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.

Department of Pediatric Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

出版信息

Hepatol Res. 2022 May;52(5):479-487. doi: 10.1111/hepr.13753. Epub 2022 Feb 15.

DOI:10.1111/hepr.13753

PMID:35106887

Abstract

BACKGROUND

Biliary atresia (BA) is among the commonest indications for liver transplantation (LT) in children. We examined whether serum matrix metalloproteinase-7 (MMP-7) is useful for diagnosis of BA in Japanese infants, and whether serum MMP-7 concentrations before and after Kasai portoenterostomy (KP) predicted LT within a year.

METHODS

Subjects under 6 months old at eight pediatric centers in Japan were enrolled retrospectively, including patients with cholestasis and normal controls (NC) without liver disease. Patients with cholestasis were divided into groups representing BA versus cholestasis from other causes (non-BA). Serum samples were collected from patients with BA at diagnosis and 1 and 4 weeks after KP, as well as from non-BA and NC.

RESULTS

Serum MMP-7 concentrations were significantly higher in BA at diagnosis (median, 89.1 ng/ml) than in non-BA (11.0; p < 0.001) or NC (10.3; p < 0.001). Receiver operating characteristic (ROC) analysis of MMP-7 for BA versus non-BA yielded an area under the ROC curve of 0.99 (95% confidence interval, 0.96-1.00). An optimal cut-off value of 18.6 ng/ml for serum MMP-7 in diagnosing BA demonstrated sensitivity and specificity of 100% and 90%, respectively. Serum MMP-7 before and 1 week and 4 weeks after KP did not differ significantly between BA requiring only KP and BA requiring LT after KP.

CONCLUSION

Serum MMP-7 is a useful marker for diagnosis of BA in Japanese infants, but it could not predict LT within a year.

摘要

背景

胆道闭锁（BA）是儿童肝移植（LT）最常见的适应证之一。我们研究了血清基质金属蛋白酶-7（MMP-7）是否有助于日本婴儿BA的诊断，以及肝门空肠吻合术（KP）前后血清MMP-7浓度能否预测一年内的肝移植情况。

方法

对日本8个儿科中心6个月以下的受试者进行回顾性研究，包括胆汁淤积患者和无肝病的正常对照（NC）。胆汁淤积患者分为BA组和其他原因引起的胆汁淤积（非BA）组。在诊断时、KP术后1周和4周采集BA患者的血清样本，同时采集非BA和NC患者的血清样本。

结果

诊断时BA患者血清MMP-7浓度（中位数，89.1 ng/ml）显著高于非BA患者（11.0；p < 0.001）或NC患者（10.3；p < 0.001）。MMP-7对BA与非BA的受试者工作特征（ROC）分析得出ROC曲线下面积为0.99（95%置信区间，0.96 - 1.00）。血清MMP-7诊断BA的最佳截断值为18.6 ng/ml，敏感性和特异性分别为100%和90%。仅需KP的BA患者与KP后需LT的BA患者在KP前、术后1周和4周的血清MMP-7无显著差异。