Karbasian Fereshteh, Mashhadiagha Amirali, Anbardar Mohammad H, Ataollahi Maryam, Dehghani Seyed M, Honar Naser, Haghighat Mahmood, Imanieh Mohammad H, Sayadi Mehrab, Shahramian Iraj, Aghsam Ali, Hosseini Amirhossein, Mahadavi Mortazavi Seyedeh M, Darban Behnaz, Avazpour Abbas, Mirrahimi Bahador, Ruzbahani Arian K, Tadayon Ali
Department of Pediatric Gastroenterology, Shiraz University of Medical Sciences, Shiraz, Iran.
Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
J Clin Exp Hepatol. 2023 Mar-Apr;13(2):265-272. doi: 10.1016/j.jceh.2022.10.001. Epub 2022 Dec 2.
Matrix metalloproteinase 7 (MMP7) has been suggested as a promising biomarker in diagnosing biliary atresia (BA). This study aimed to assess the diagnostic accuracy of serum MMP7 in BA in the Middle Eastern population.
In this cross-sectional study, neonates and infants with direct hyperbilirubinemia admitted to Namazi referral hospital, Shiraz, Iran, were studied. Baseline demographic and clinical characteristics and blood samples were obtained on admission. MMP7 serum concentration was measured using an enzyme-linked immunosorbent assay (ZellBio GmbH, Ulm, Germany).
44 infants with a mean age of 65.59 days were studied. Of these patients, 13 cases were diagnosed with BA, and 31 cases' cholestasis related to other etiologies. Serum MMP7 concertation was 2.13 ng/mL in the BA group and 1.85 ng/mL in the non-BA group. MMP7 was significantly higher in those presented with either dark urine or acholic stool. The predictive performance capability of the MMP7 was not significant in the discrimination of BA from the non-BA group based on receiver operating characteristic curve analysis (area under curve: 0.6, 95% confidence interval: 0.45-0.75). In the optimal cut of point 1.9, the sensitivity and specificity were 84.6% and 45.1%, respectively. Further combination of MMP7 with Gamma-glutamyl transferase (GGT), alkaline phosphatase, direct and total bilirubin, and dark urine or acholic stool was not remarkably boosted the diagnostic accuracy of the test. Interestingly, GGT at a cut-off point of 230 U/L was 84.6% sensitive and 90.3% specific for BA.
Our results are not consistent with previous studies on this subject. Considering more conventional and available tests like GGT besides conducting future studies with greater samples and different geographical areas is recommended.
基质金属蛋白酶7（MMP7）被认为是诊断胆道闭锁（BA）的一种有前景的生物标志物。本研究旨在评估中东人群中血清MMP7对BA的诊断准确性。
在这项横断面研究中，对伊朗设拉子纳马齐转诊医院收治的直接胆红素血症的新生儿和婴儿进行了研究。入院时获取基线人口统计学和临床特征以及血样。使用酶联免疫吸附测定法（德国乌尔姆的ZellBio GmbH公司）测量血清MMP7浓度。
研究了44例平均年龄为65.59天的婴儿。其中，13例被诊断为BA，31例胆汁淤积与其他病因有关。BA组血清MMP7浓度为2.13 ng/mL，非BA组为1.85 ng/mL。有深色尿液或无胆汁粪便的患者中MMP7显著更高。基于受试者工作特征曲线分析，MMP7在区分BA组和非BA组方面的预测性能不显著（曲线下面积：0.6，95%置信区间：0.45 - 0.75）。在最佳切点1.9时，敏感性和特异性分别为84.6%和45.1%。MMP7与γ-谷氨酰转移酶（GGT）、碱性磷酸酶、直接胆红素和总胆红素以及深色尿液或无胆汁粪便的进一步联合并没有显著提高检测的诊断准确性。有趣的是，GGT在切点为230 U/L时对BA的敏感性为84.6%，特异性为90.3%。
我们的结果与之前关于该主题的研究不一致。建议除了进行更大样本量和不同地理区域的未来研究外，还要考虑更常规和可用的检测方法，如GGT。
