The Second Department of General Surgery, Children's Hospital of Hebei, Shijiazhuang City, Hebei Province, China.
Medicine (Baltimore). 2022 Aug 12;101(32):e29752. doi: 10.1097/MD.0000000000029752.
Hyaluronic acid (HA), type III procollagen III (PC-III), type IV collagen IV (IV-C), and laminin (LN) have certain diagnostic value for hepatobiliary diseases. No published studies have compared the diagnostic accuracy of these 4 indicators for the diagnosis of congenital biliary atresia (CBA) in infants. This study aimed to investigate the diagnostic value of HA, PC-III, IV-C, and LN in infants with CBA. From January 2017 to December 2020, 185 infants with nonphysiological jaundice in the Second Department of General Surgery at the Children's Hospital of Hebei were enrolled in this study. Forty-six infants with CBA (CBA group) and 139 infants without CBA (noncongenital biliary atresia group) were diagnosed using ultrasonography, magnetic resonance imaging, intraoperative exploration, and intraoperative cholangiography. The levels of HA, PC-III, IV-C, and LN in the 2 groups were statistically analyzed. The diagnostic accuracy was determined using receiver operating characteristic curves and by calculating the area under the curve. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors. Compared to the noncongenital biliary atresia group, the levels of HA, PC-III, IV-C, and LN were significantly increased in the CBA group (P <.05). The receiver operating characteristic analysis showed the optimal cutoff values for HA, PC-III, IV-C, and LN were 162.7, 42.5, 199.7, and 101.2 ng/mL, and the area under the curves were 0.892, 0.762, 0.804, and 0.768, respectively. The sensitivity values for the diagnosis of CBA were 76.82%, 71.61%, 70.32%, and 72.28%, and the specificity values for the diagnosis of biliary atresia were 70.22%, 70.44%, 66.34%, and 68.71%, respectively. In the multivariate model, HA ≥162.7 ng/mL (odds ratio [OR] = 5.28, 95% confidence interval [CI]: 3.15-8.37), PC-III ≥42.5 ng/mL (OR = 4.61, 95% CI: 2.54-7.16), IV-C ≥199.7 ng/mL (OR = 5.02, 95% CI: 2.98-7.64), and LN ≥101.2 ng/mL (OR = 6.25, 95% CI: 2.41-10.07) remained associated with the occurrence of CBA. HA, PC-III, IV-C, and LN have high accuracy for the diagnosis of CBA in infants, and these factors are potential diagnostic biomarkers for CBA.
透明质酸（HA）、III 型前胶原（PC-III）、IV 型胶原（IV-C）和层粘连蛋白（LN）对肝胆疾病具有一定的诊断价值。目前尚未有研究比较这 4 种指标在诊断婴儿先天性胆道闭锁（CBA）中的诊断准确性。本研究旨在探讨 HA、PC-III、IV-C 和 LN 在婴儿 CBA 中的诊断价值。2017 年 1 月至 2020 年 12 月，我院普外科二科收治了 185 例非生理性黄疸婴儿。46 例 CBA 患儿（CBA 组）和 139 例非 CBA 患儿（非先天性胆道闭锁组）经超声、磁共振成像、术中探查和术中胆管造影确诊。统计分析两组 HA、PC-III、IV-C 和 LN 水平。采用受试者工作特征曲线和计算曲线下面积来确定诊断准确性。进行单因素和多因素逻辑回归分析，以确定独立的危险因素。与非先天性胆道闭锁组相比，CBA 组 HA、PC-III、IV-C 和 LN 水平显著升高（P＜0.05）。受试者工作特征分析显示，HA、PC-III、IV-C 和 LN 的最佳截断值分别为 162.7、42.5、199.7 和 101.2ng/ml，曲线下面积分别为 0.892、0.762、0.804 和 0.768。CBA 的诊断敏感度分别为 76.82%、71.61%、70.32%和 72.28%，诊断胆道闭锁的特异度分别为 70.22%、70.44%、66.34%和 68.71%。多因素模型中，HA≥162.7ng/ml（比值比[OR]＝5.28，95%置信区间[CI]：3.15-8.37）、PC-III≥42.5ng/ml（OR＝4.61，95%CI：2.54-7.16）、IV-C≥199.7ng/ml（OR＝5.02，95%CI：2.98-7.64）和 LN≥101.2ng/ml（OR＝6.25，95%CI：2.41-10.07）与 CBA 的发生仍相关。HA、PC-III、IV-C 和 LN 对婴儿 CBA 的诊断具有较高的准确性，这些因素可能是 CBA 的潜在诊断生物标志物。
