Wang Haojun, Liu Hui, Li Wanfu, Keranmu Ainiwaer, Liang Peng, Wang Yaqi, Zhang Tao, Jiayilawu Yeliaman
Department of Pediatric General Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
Front Pharmacol. 2025 Jun 26;16:1581053. doi: 10.3389/fphar.2025.1581053. eCollection 2025.
Biliary atresia (BA) is an obstructive fibrotic disorder that typically progresses to cirrhosis and, ultimately, death in children. Current gold standard diagnostics for BA include intraoperative cholangiography and liver biopsy, both invasive procedures with significant complication risks. Matrix metalloproteinase-7 (MMP-7) has emerged as a highly accurate noninvasive diagnostic biomarker for BA. This study therefore aimed to evaluate the diagnostic utility of serum MMP-7 for BA detection.
We performed a comprehensive search of English-language databases (PubMed, Web of Science, ScienceDirect) with literature from the inception of these databases through 30 November 2024. Study quality was assessed using the QUADAS-2 tool. Sensitivity, specificity, positive/negative likelihood ratios (PLR/NLR), and area under the receiver operating characteristic curve (AUC-ROC) were calculated using Meta-DiSc 1.4 and STATA 18.0.
This systematic review and meta-analysis included 13 articles (17 studies) comprising 2,836 serum samples from pediatric subjects. Binary classification model analysis showed pooled sensitivity of 0.93 (95% CI: 0.92-0.94) and specificity of 0.85 (95% CI: 0.83-0.87) for MMP-7. Positive likelihood ratio (PLR) was 7.68 (95%CI: 5.04-11.72), the negative likelihood ratio (NLR) was 0.08 (95%CI: 0.05-0.14), and the diagnosis odds ratio (DOR) was 104.34 (95%CI: 55.97-194.51). AUC was 0.9628. Meta-regression analysis identified publication year as a significant heterogeneity source (p = 0.007). Sensitivity analysis confirmed the robust diagnostic stability of MMP-7 for BA. Significant heterogeneity was observed across studies (I = 78.6%). Subgroup analysis by publication year showed that heterogeneity primarily originated from studies published in or after 2023.
Serum MMP-7 represents a convenient, accurate, and reliable noninvasive biomarker for enhancing BA diagnostic efficiency. However, due to significant heterogeneity, further validation via large-scale, multicenter studies with standardized protocols is needed.
https://www.crd.york.ac.uk/PROSPERO/recorddashboard, identifier CRD42024623643.
胆道闭锁（BA）是一种阻塞性纤维化疾病，在儿童中通常会发展为肝硬化并最终导致死亡。目前BA的金标准诊断方法包括术中胆管造影和肝活检，这两种都是侵入性操作，具有显著的并发症风险。基质金属蛋白酶-7（MMP-7）已成为一种用于BA的高度准确的非侵入性诊断生物标志物。因此，本研究旨在评估血清MMP-7在BA检测中的诊断效用。
我们对英文数据库（PubMed、Web of Science、ScienceDirect）进行了全面检索，纳入了从这些数据库建立之初到2024年11月30日的文献。使用QUADAS-2工具评估研究质量。使用Meta-DiSc 1.4和STATA 18.0计算敏感性、特异性、阳性/阴性似然比（PLR/NLR）以及受试者工作特征曲线下面积（AUC-ROC）。
本系统评价和荟萃分析纳入了13篇文章（17项研究），包含来自儿科受试者的2836份血清样本。二元分类模型分析显示，MMP-7的合并敏感性为0.93（95%CI：0.92 - 0.94），特异性为0.85（95%CI：0.83 - 0.87）。阳性似然比（PLR）为7.68（95%CI：5.04 - 11.72），阴性似然比（NLR）为0.08（95%CI：0.05 - 0.14），诊断比值比（DOR）为104.34（95%CI：55.97 - 194.51）。AUC为0.9628。Meta回归分析确定发表年份是一个显著的异质性来源（p = 0.007）。敏感性分析证实了MMP-7对BA具有稳健的诊断稳定性。各研究间观察到显著的异质性（I² = 78.6%）。按发表年份进行的亚组分析表明，异质性主要源于2023年及以后发表的研究。
血清MMP-7是一种方便、准确且可靠的非侵入性生物标志物，可提高BA的诊断效率。然而，由于存在显著异质性，需要通过大规模、多中心且方案标准化的研究进行进一步验证。
https://www.crd.york.ac.uk/PROSPERO/recorddashboard，标识符CRD42024623643 。
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