Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China.
Department of General Surgery, Capital Institute of Pediatrics, Beijing, China.
BMC Surg. 2024 Jun 24;24(1):195. doi: 10.1186/s12893-024-02488-y.
Matrix metalloproteinase-7 (MMP-7) is associated with biliary injury. This study aimed to evaluate the relationships of serum MMP-7 with clinical characteristics in choledochal cysts (CDC) children.
Between June 2020 and July 2022, we conducted a prospective study of CDCs who underwent one-stage definitive operation at our center. Serum MMP-7 was measured using an enzyme-linked immunosorbent assay. We evaluated the relationships between serum MMP-7 and age, laboratory tests, imaging examinations, liver fibrosis, MMP-7 expression, and perforation.
A total of 328 CDCs were enrolled in the study, with a median serum MMP-7 of 7.67 ng/mL. Higher serum MMP-7 was correlated with younger age at diagnosis (p < 0.001), larger cyst sizes (p < 0.001), higher liver fibrosis stages (p < 0.001), and higher incidence of perforation (p < 0.01). Liver MMP-7 was mainly expressed in intrahepatic and extrahepatic biliary epithelial cells. The area under the receiver operating characteristic curve (AUROC) was 0.630 (p < 0.001) for serum MMP-7 in predicting perforation. When serum MMP-7 was combined with γ-glutamyl transferase (GGT), the AUROC increased to 0.706 (p < 0.001).
Serum MMP-7 was associated with biliary obstruction in CDCs. Patients with high serum MMP-7 were more likely to have severe liver damage and biliary injury, with higher incidences of liver fibrosis and perforation.
基质金属蛋白酶-7(MMP-7)与胆管损伤有关。本研究旨在评估血清 MMP-7 与胆总管囊肿(CDC)患儿临床特征的关系。
2020 年 6 月至 2022 年 7 月,我们对在我院行一期确定性手术的 CDC 患儿进行了一项前瞻性研究。采用酶联免疫吸附试验测定血清 MMP-7。我们评估了血清 MMP-7 与年龄、实验室检查、影像学检查、肝纤维化、MMP-7 表达和穿孔之间的关系。
共纳入 328 例 CDC 患儿,血清 MMP-7 中位数为 7.67ng/mL。较高的血清 MMP-7 与诊断时年龄较小(p<0.001)、囊肿较大(p<0.001)、肝纤维化分期较高(p<0.001)和穿孔发生率较高(p<0.01)相关。肝 MMP-7 主要在肝内和肝外胆管上皮细胞中表达。血清 MMP-7 预测穿孔的受试者工作特征曲线下面积(AUROC)为 0.630(p<0.001)。当血清 MMP-7 与γ-谷氨酰转移酶(GGT)联合使用时,AUROC 增加至 0.706(p<0.001)。
血清 MMP-7 与 CDC 中的胆道梗阻有关。血清 MMP-7 水平较高的患者更有可能发生严重的肝损伤和胆道损伤,肝纤维化和穿孔的发生率更高。